HDR CPT CODES AND DESCRIPTIONS ONLY ARE COPYRIGHT
HDR 2008 AMERICAN MEDICAL ASSOCIATION.  ALL RIGHTS
HDR RESERVED.  APPLICABLE FARS/DFARS APPLY.
HDR THE FOLLOWING STATEMENT APPLIES TO ALL DENTAL
HDR CODES (HCPCS START WITH LETTER D):  COPYRIGHT
HDR 2002 AMERICAN DENTAL ASSOCIATION.  ALL RIGHTS
HDR RESERVED.
A0021  Outside state ambulance serv                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0080  Noninterest escort in non er                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0090  Interest escort in non er                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0100  Nonemergency transport taxi                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0110  Nonemergency transport bus                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0120  Noner transport mini-bus                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0130  Noner transport wheelch van                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0140  Nonemergency transport air                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0160  Noner transport case worker                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0170  Transport parking fees/tolls                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0180  Noner transport lodgng recip                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0190  Noner transport meals recip                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0200  Noner transport lodgng escrt                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0210  Noner transport meals escort                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0225  Neonatal emergency transport                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0380  Basic life support mileage                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0382  Basic support routine suppls                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0384  Bls defibrillation supplies                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0390  Advanced life support mileag                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0392  Als defibrillation supplies                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0394  Als IV drug therapy supplies                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0396  Als esophageal intub suppls                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0398  Als routine disposble suppls                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0420  Ambulance waiting 1/2 hr                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0422  Ambulance 02 life sustaining                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0424  Extra ambulance attendant                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0425  Ground mileage                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0426  Als 1                                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0427  ALS1-emergency                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0428  bls                                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0429  BLS-emergency                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0430  Fixed wing air transport                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0431  Rotary wing air transport                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0432  PI volunteer ambulance co                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0433  als 2                                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0434  Specialty care transport                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0435  Fixed wing air mileage                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0436  Rotary wing air mileage                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0888  Noncovered ambulance mileage                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0998  Ambulance response/treatment                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A0999  Unlisted ambulance service                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4206  1 CC sterile syringe&needle                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4207  2 CC sterile syringe&needle                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4208  3 CC sterile syringe&needle                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4209  5+ CC sterile syringe&needle                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4210  Nonneedle injection device                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4211  Supp for self-adm injections                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4212  Non coring needle or stylet                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4213  20+ CC syringe only                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4215  Sterile needle                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4216  Sterile water/saline, 10 ml                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4217  Sterile water/saline, 500 ml                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4218  Sterile saline or water                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4220  Infusion pump refill kit                          P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4221  Maint drug infus cath per wk                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4222  Infusion supplies with pump                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4223  Infusion supplies w/o pump                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4230  Infus insulin pump non needl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4231  Infusion insulin pump needle                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4232  Syringe w/needle insulin 3cc                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4233  Alkalin batt for glucose mon                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4234  J-cell batt for glucose mon                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4235  Lithium batt for glucose mon                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4236  Silvr oxide batt glucose mon                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4244  Alcohol or peroxide per pint                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4245  Alcohol wipes per box                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4246  Betadine/phisohex solution                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4247  Betadine/iodine swabs/wipes                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4248  Chlorhexidine antisept                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4250  Urine reagent strips/tablets                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4252  Blood ketone test or strip                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4253  Blood glucose/reagent strips                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4255  Glucose monitor platforms                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4256  Calibrator solution/chips                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4257  Replace Lensshield Cartridge                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4258  Lancet device each                                P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4259  Lancets per box                                   P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4261  Cervical cap contraceptive                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4262  Temporary tear duct plug                          B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4263  Permanent tear duct plug                          B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4264  Intratubal occlusion device                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4265  Paraffin                                          P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4266  Diaphragm                                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4267  Male condom                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4268  Female condom                                     I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4269  Spermicide                                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4270  Disposable endoscope sheath                       B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4280  Brst prsths adhsv attchmnt                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4281  Replacement breastpump tube                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4282  Replacement breastpump adpt                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4283  Replacement breastpump cap                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4284  Replcmnt breast pump shield                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4285  Replcmnt breast pump bottle                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4286  Replcmnt breastpump lok ring                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4290  Sacral nerve stim test lead                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4300  Cath impl vasc access portal                      B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4301  Implantable access syst perc                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4305  Drug delivery system >=50 ML                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4306  Drug delivery system <=50 ml                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4310  Insert tray w/o bag/cath                          P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4311  Catheter w/o bag 2-way latex                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4312  Cath w/o bag 2-way silicone                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4313  Catheter w/bag 3-way                              P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4314  Cath w/drainage 2-way latex                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4315  Cath w/drainage 2-way silcne                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4316  Cath w/drainage 3-way                             P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4320  Irrigation tray                                   P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4321  Cath therapeutic irrig agent                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4322  Irrigation syringe                                P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4326  Male external catheter                            P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4327  Fem urinary collect dev cup                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4328  Fem urinary collect pouch                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4330  Stool collection pouch                            P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4331  Extension drainage tubing                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4332  Lube sterile packet                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4333  Urinary cath anchor device                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4334  Urinary cath leg strap                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4335  Incontinence supply                               P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4336  Urethral insert                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4338  Indwelling catheter latex                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4340  Indwelling catheter special                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4344  Cath indw foley 2 way silicn                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4346  Cath indw foley 3 way                             P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4349  Disposable male external cat                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4351  Straight tip urine catheter                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4352  Coude tip urinary catheter                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4353  Intermittent urinary cath                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4354  Cath insertion tray w/bag                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4355  Bladder irrigation tubing                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4356  Ext ureth clmp or compr dvc                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4357  Bedside drainage bag                              P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4358  Urinary leg or abdomen bag                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4360  Disposable ext urethral dev                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4361  Ostomy face plate                                 P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4362  Solid skin barrier                                P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4363  Ostomy clamp, replacement                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4364  Adhesive, liquid or equal                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4366  Ostomy vent                                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4367  Ostomy belt                                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4368  Ostomy filter                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4369  Skin barrier liquid per oz                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4371  Skin barrier powder per oz                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4372  Skin barrier solid 4x4 equiv                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4373  Skin barrier with flange                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4375  Drainable plastic pch w fcpl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4376  Drainable rubber pch w fcplt                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4377  Drainable plstic pch w/o fp                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4378  Drainable rubber pch w/o fp                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4379  Urinary plastic pouch w fcpl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4380  Urinary rubber pouch w fcplt                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4381  Urinary plastic pouch w/o fp                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4382  Urinary hvy plstc pch w/o fp                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4383  Urinary rubber pouch w/o fp                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4384  Ostomy faceplt/silicone ring                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4385  Ost skn barrier sld ext wear                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4387  Ost clsd pouch w att st barr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4388  Drainable pch w ex wear barr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4389  Drainable pch w st wear barr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4390  Drainable pch ex wear convex                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4391  Urinary pouch w ex wear barr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4392  Urinary pouch w st wear barr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4393  Urine pch w ex wear bar conv                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4394  Ostomy pouch liq deodorant                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4395  Ostomy pouch solid deodorant                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4396  Peristomal hernia supprt blt                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4397  Irrigation supply sleeve                          P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4398  Ostomy irrigation bag                             P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4399  Ostomy irrig cone/cath w brs                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4400  Ostomy irrigation set                             P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4402  Lubricant per ounce                               P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4404  Ostomy ring each                                  P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4405  Nonpectin based ostomy paste                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4406  Pectin based ostomy paste                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4407  Ext wear ost skn barr <=4sq"                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4408  Ext wear ost skn barr >4sq"                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4409  Ost skn barr convex <=4 sq i                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4410  Ost skn barr extnd >4 sq                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4411  Ost skn barr extnd =4sq                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4412  Ost pouch drain high output                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4413  2 pc drainable ost pouch                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4414  Ost sknbar w/o conv<=4 sq in                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4415  Ost skn barr w/o conv >4 sqi                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4416  Ost pch clsd w barrier/filtr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4417  Ost pch w bar/bltinconv/fltr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4418  Ost pch clsd w/o bar w filtr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4419  Ost pch for bar w flange/flt                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4420  Ost pch clsd for bar w lk fl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4421  Ostomy supply misc                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4422  Ost pouch absorbent material                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4423  Ost pch for bar w lk fl/fltr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4424  Ost pch drain w bar & filter                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4425  Ost pch drain for barrier fl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4426  Ost pch drain 2 piece system                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4427  Ost pch drain/barr lk flng/f                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4428  Urine ost pouch w faucet/tap                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4429  Urine ost pouch w bltinconv                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4430  Ost urine pch w b/bltin conv                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4431  Ost pch urine w barrier/tapv                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4432  Os pch urine w bar/fange/tap                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4433  Urine ost pch bar w lock fln                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4434  Ost pch urine w lock flng/ft                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4450  Non-waterproof tape                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4452  Waterproof tape                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4455  Adhesive remover per ounce                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4456  Adhesive remover, wipes                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4458  Reusable enema bag                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4461  Surgicl dress hold non-reuse                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4463  Surgical dress holder reuse                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4465  Non-elastic extremity binder                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4466  Elastic garment/covering                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4470  Gravlee jet washer                                P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4480  Vabra aspirator                                   P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4481  Tracheostoma filter                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4483  Moisture exchanger                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4490  Above knee surgical stocking                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4495  Thigh length surg stocking                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4500  Below knee surgical stocking                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4510  Full length surg stocking                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4520  Incontinence garment anytype                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4550  Surgical trays                                    B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4554  Disposable underpads                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4556  Electrodes, pair                                  P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4557  Lead wires, pair                                  P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4558  Conductive gel or paste                           P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4559  Coupling gel or paste                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4561  Pessary rubber, any type                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4562  Pessary, non rubber,any type                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4565  Slings                                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4566  Should sling/vest/abrestrain                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4570  Splint                                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4575  Hyperbaric o2 chamber disps                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4580  Cast supplies (plaster)                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4590  Special casting material                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4595  TENS suppl 2 lead per month                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4600  Sleeve, inter limb comp dev                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4601  Lith ion batt, non-pros use                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4604  Tubing with heating element                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4605  Trach suction cath close sys                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4606  Oxygen probe used w oximeter                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4608  Transtracheal oxygen cath                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4611  Heavy duty battery                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4612  Battery cables                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4613  Battery charger                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4614  Hand-held PEFR meter                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4615  Cannula nasal                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4616  Tubing (oxygen) per foot                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4617  Mouth piece                                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4618  Breathing circuits                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4619  Face tent                                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4620  Variable concentration mask                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4623  Tracheostomy inner cannula                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4624  Tracheal suction tube                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4625  Trach care kit for new trach                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4626  Tracheostomy cleaning brush                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4627  Spacer bag/reservoir                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4628  Oropharyngeal suction cath                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4629  Tracheostomy care kit                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4630  Repl bat t.e.n.s. own by pt                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4633  Uvl replacement bulb                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4634  Replacement bulb th lightbox                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4635  Underarm crutch pad                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4636  Handgrip for cane etc                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4637  Repl tip cane/crutch/walker                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4638  Repl batt pulse gen sys                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4639  Infrared ht sys replcmnt pad                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4640  Alternating pressure pad                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4641  Radiopharm dx agent noc                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A4642  In111 satumomab                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A4648  Implantable tissue marker                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4649  Surgical supplies                                 P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4650  Implant radiation dosimeter                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4651  Calibrated microcap tube                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4652  Microcapillary tube sealant                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4653  PD catheter anchor belt                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4657  Syringe w/wo needle                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4660  Sphyg/bp app w cuff and stet                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4663  Dialysis blood pressure cuff                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4670  Automatic bp monitor, dial                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4671  Disposable cycler set                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4672  Drainage ext line, dialysis                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4673  Ext line w easy lock connect                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4674  Chem/antisept solution, 8oz                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4680  Activated carbon filter, ea                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4690  Dialyzer, each                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4706  Bicarbonate conc sol per gal                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4707  Bicarbonate conc pow per pac                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4708  Acetate conc sol per gallon                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4709  Acid conc sol per gallon                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4714  Treated water per gallon                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4719  "Y set" tubing                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4720  Dialysat sol fld vol > 249cc                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4721  Dialysat sol fld vol > 999cc                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4722  Dialys sol fld vol > 1999cc                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4723  Dialys sol fld vol > 2999cc                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4724  Dialys sol fld vol > 3999cc                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4725  Dialys sol fld vol > 4999cc                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4726  Dialys sol fld vol > 5999cc                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4728  Dialysate solution, non-dex                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4730  Fistula cannulation set, ea                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4736  Topical anesthetic, per gram                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4737  Inj anesthetic per 10 ml                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4740  Shunt accessory                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4750  Art or venous blood tubing                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4755  Comb art/venous blood tubing                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4760  Dialysate sol test kit, each                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4765  Dialysate conc pow per pack                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4766  Dialysate conc sol add 10 ml                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4770  Blood collection tube/vacuum                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4771  Serum clotting time tube                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4772  Blood glucose test strips                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4773  Occult blood test strips                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4774  Ammonia test strips                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4802  Protamine sulfate per 50 mg                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4860  Disposable catheter tips                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4870  Plumb/elec wk hm hemo equip                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4890  Repair/maint cont hemo equip                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A4911  Drain bag/bottle                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4913  Misc dialysis supplies noc                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4918  Venous pressure clamp                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4927  Non-sterile gloves                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4928  Surgical mask                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4929  Tourniquet for dialysis, ea                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4930  Sterile, gloves per pair                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4931  Reusable oral thermometer                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A4932  Reusable rectal thermometer                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5051  Pouch clsd w barr attached                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5052  Clsd ostomy pouch w/o barr                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5053  Clsd ostomy pouch faceplate                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5054  Clsd ostomy pouch w/flange                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5055  Stoma cap                                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5061  Pouch drainable w barrier at                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5062  Drnble ostomy pouch w/o barr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5063  Drain ostomy pouch w/flange                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5071  Urinary pouch w/barrier                           P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5072  Urinary pouch w/o barrier                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5073  Urinary pouch on barr w/flng                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5081  Continent stoma plug                              P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5082  Continent stoma catheter                          P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5083  Stoma absorptive cover                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5093  Ostomy accessory convex inse                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5102  Bedside drain btl w/wo tube                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5105  Urinary suspensory                                P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5112  Urinary leg bag                                   P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5113  Latex leg strap                                   P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5114  Foam/fabric leg strap                             P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5120  Skin barrier, wipe or swab                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5121  Solid skin barrier 6x6                            P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5122  Solid skin barrier 8x8                            P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5126  Disk/foam pad +or- adhesive                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5131  Appliance cleaner                                 P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5200  Percutaneous catheter anchor                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5500  Diab shoe for density insert                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5501  Diabetic custom molded shoe                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5503  Diabetic shoe w/roller/rockr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5504  Diabetic shoe with wedge                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5505  Diab shoe w/metatarsal bar                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5506  Diabetic shoe w/off set heel                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5507  Modification diabetic shoe                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5508  Diabetic deluxe shoe                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5510  Compression form shoe insert                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5512  Multi den insert direct form                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A5513  Multi den insert custom mold                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6000  Wound warming wound cover                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6010  Collagen based wound filler                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6011  Collagen gel/paste wound fil                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6021  Collagen dressing <=16 sq in                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6022  Collagen drsg>16<=48 sq in                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6023  Collagen dressing >48 sq in                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6024  Collagen dsg wound filler                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6025  Silicone gel sheet, each                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6154  Wound pouch each                                  P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6196  Alginate dressing <=16 sq in                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6197  Alginate drsg >16 <=48 sq in                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6198  alginate dressing > 48 sq in                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6199  Alginate drsg wound filler                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6203  Composite drsg <= 16 sq in                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6204  Composite drsg >16<=48 sq in                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6205  Composite drsg > 48 sq in                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6206  Contact layer <= 16 sq in                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6207  Contact layer >16<= 48 sq in                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6208  Contact layer > 48 sq in                          P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6209  Foam drsg <=16 sq in w/o bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6210  Foam drg >16<=48 sq in w/o b                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6211  Foam drg > 48 sq in w/o brdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6212  Foam drg <=16 sq in w/border                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6213  Foam drg >16<=48 sq in w/bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6214  Foam drg > 48 sq in w/border                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6215  Foam dressing wound filler                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6216  Non-sterile gauze<=16 sq in                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6217  Non-sterile gauze>16<=48 sq                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6218  Non-sterile gauze > 48 sq in                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6219  Gauze <= 16 sq in w/border                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6220  Gauze >16 <=48 sq in w/bordr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6221  Gauze > 48 sq in w/border                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6222  Gauze <=16 in no w/sal w/o b                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6223  Gauze >16<=48 no w/sal w/o b                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6224  Gauze > 48 in no w/sal w/o b                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6228  Gauze <= 16 sq in water/sal                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6229  Gauze >16<=48 sq in watr/sal                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6230  Gauze > 48 sq in water/salne                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6231  Hydrogel dsg<=16 sq in                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6232  Hydrogel dsg>16<=48 sq in                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6233  Hydrogel dressing >48 sq in                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6234  Hydrocolld drg <=16 w/o bdr                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6235  Hydrocolld drg >16<=48 w/o b                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6236  Hydrocolld drg > 48 in w/o b                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6237  Hydrocolld drg <=16 in w/bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6238  Hydrocolld drg >16<=48 w/bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6239  Hydrocolld drg > 48 in w/bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6240  Hydrocolld drg filler paste                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6241  Hydrocolloid drg filler dry                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6242  Hydrogel drg <=16 in w/o bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6243  Hydrogel drg >16<=48 w/o bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6244  Hydrogel drg >48 in w/o bdr                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6245  Hydrogel drg <= 16 in w/bdr                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6246  Hydrogel drg >16<=48 in w/b                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6247  Hydrogel drg > 48 sq in w/b                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6248  Hydrogel drsg gel filler                          P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6250  Skin seal protect moisturizr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6251  Absorpt drg <=16 sq in w/o b                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6252  Absorpt drg >16 <=48 w/o bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6253  Absorpt drg > 48 sq in w/o b                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6254  Absorpt drg <=16 sq in w/bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6255  Absorpt drg >16<=48 in w/bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6256  Absorpt drg > 48 sq in w/bdr                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6257  Transparent film <= 16 sq in                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6258  Transparent film >16<=48 in                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6259  Transparent film > 48 sq in                       P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6260  Wound cleanser any type/size                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6261  Wound filler gel/paste /oz                        P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6262  Wound filler dry form / gram                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6266  Impreg gauze no h20/sal/yard                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6402  Sterile gauze <= 16 sq in                         P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6403  Sterile gauze>16 <= 48 sq in                      P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6404  Sterile gauze > 48 sq in                          P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6407  Packing strips, non-impreg                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6410  Sterile eye pad                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6411  Non-sterile eye pad                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6412  Occlusive eye patch                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6413  Adhesive bandage, first-aid                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6441  Pad band w>=3" <5"/yd                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6442  Conform band n/s w<3"/yd                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6443  Conform band n/s w>=3"<5"/yd                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6444  Conform band n/s w>=5"/yd                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6445  Conform band s w <3"/yd                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6446  Conform band s w>=3" <5"/yd                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6447  Conform band s w >=5"/yd                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6448  Lt compres band <3"/yd                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6449  Lt compres band >=3" <5"/yd                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6450  Lt compres band >=5"/yd                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6451  Mod compres band w>=3"<5"/yd                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6452  High compres band w>=3"<5"yd                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6453  Self-adher band w <3"/yd                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6454  Self-adher band w>=3" <5"/yd                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6455  Self-adher band >=5"/yd                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6456  Zinc paste band w >=3"<5"/yd                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6457  Tubular dressing                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6501  Compres burngarment bodysuit                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6502  Compres burngarment chinstrp                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6503  Compres burngarment facehood                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6504  Cmprsburngarment glove-wrist                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6505  Cmprsburngarment glove-elbow                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6506  Cmprsburngrmnt glove-axilla                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6507  Cmprs burngarment foot-knee                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6508  Cmprs burngarment foot-thigh                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6509  Compres burn garment jacket                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6510  Compres burn garment leotard                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6511  Compres burn garment panty                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6512  Compres burn garment, noc                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6513  Compress burn mask face/neck                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6530  Compression stocking BK18-30                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6531  Compression stocking BK30-40                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6532  Compression stocking BK40-50                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6533  Gc stocking thighlngth 18-30                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6534  Gc stocking thighlngth 30-40                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6535  Gc stocking thighlngth 40-50                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6536  Gc stocking full lngth 18-30                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6537  Gc stocking full lngth 30-40                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6538  Gc stocking full lngth 40-50                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6539  Gc stocking waistlngth 18-30                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6540  Gc stocking waistlngth 30-40                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6541  Gc stocking waistlngth 40-50                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6544  Gc stocking garter belt                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6545  Grad comp non-elastic BK                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6549  G compression stocking                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A6550  Neg pres wound ther drsg set                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7000  Disposable canister for pump                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7001  Nondisposable pump canister                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7002  Tubing used w suction pump                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7003  Nebulizer administration set                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7004  Disposable nebulizer sml vol                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7005  Nondisposable nebulizer set                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7006  Filtered nebulizer admin set                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7007  Lg vol nebulizer disposable                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7008  Disposable nebulizer prefill                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7009  Nebulizer reservoir bottle                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7010  Disposable corrugated tubing                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7011  Nondispos corrugated tubing                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7012  Nebulizer water collec devic                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7013  Disposable compressor filter                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7014  Compressor nondispos filter                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7015  Aerosol mask used w nebulize                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7016  Nebulizer dome & mouthpiece                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7017  Nebulizer not used w oxygen                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7018  Water distilled w/nebulizer                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7020  Interface, cough stim device                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7025  Replace chest compress vest                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7026  Replace chst cmprss sys hose                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7027  Combination oral/nasal mask                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7028  Repl oral cushion combo mask                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7029  Repl nasal pillow comb mask                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7030  CPAP full face mask                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7031  Replacement facemask interfa                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7032  Replacement nasal cushion                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7033  Replacement nasal pillows                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7034  Nasal application device                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7035  Pos airway press headgear                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7036  Pos airway press chinstrap                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7037  Pos airway pressure tubing                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7038  Pos airway pressure filter                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7039  Filter, non disposable w pap                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7040  One way chest drain valve                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7041  Water seal drain container                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7042  Implanted pleural catheter                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7043  Vacuum drainagebottle/tubing                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7044  PAP oral interface                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7045  Repl exhalation port for PAP                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7046  Repl water chamber, PAP dev                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7501  Tracheostoma valve w diaphra                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7502  Replacement diaphragm/fplate                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7503  HMES filter holder or cap                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7504  Tracheostoma HMES filter                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7505  HMES or trach valve housing                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7506  HMES/trachvalve adhesivedisk                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7507  Integrated filter & holder                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7508  Housing & Integrated Adhesiv                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7509  Heat & moisture exchange sys                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7520  Trach/laryn tube non-cuffed                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7521  Trach/laryn tube cuffed                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7522  Trach/laryn tube stainless                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7523  Tracheostomy shower protect                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7524  Tracheostoma stent/stud/bttn                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7525  Tracheostomy mask                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7526  Tracheostomy tube collar                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A7527  Trach/laryn tube plug/stop                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A8000  Soft protect helmet prefab                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A8001  Hard protect helmet prefab                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A8002  Soft protect helmet custom                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A8003  Hard protect helmet custom                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A8004  Repl soft interface, helmet                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9150  Misc/exper non-prescript dru                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9152  Single vitamin nos                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9153  Multi-vitamin nos                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9155  Artificial saliva                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9180  Lice treatment, topical                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9270  Non-covered item or service                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9273  Hot/cold h2obot/cap/col/wrap                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9274  Ext amb insulin delivery sys                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9275  Disp home glucose monitor                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9276  Disposable sensor, CGM sys                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9277  External transmitter, CGM                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9278  External receiver, CGM sys                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9279  Monitoring feature/deviceNOC                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9280  Alert device, noc                                 N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9281  Reaching/grabbing device                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9282  Wig any type                                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9283  Foot press off load supp dev                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9284  Non-electronic spirometer                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9300  Exercise equipment                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9500  Tc99m sestamibi                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9501  Technetium TC-99m teboroxime                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9502  Tc99m tetrofosmin                                 C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9503  Tc99m medronate                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9504  Tc99m apcitide                                    C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9505  TL201 thallium                                    C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9507  In111 capromab                                    C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9508  I131 iodobenguate, dx                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9509  Iodine I-123 sod iodide mil                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9510  Tc99m disofenin                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9512  Tc99m pertechnetate                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9516  Iodine I-123 sod iodide mic                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9517  I131 iodide cap, rx                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9521  Tc99m exametazime                                 C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9524  I131 serum albumin, dx                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9526  Nitrogen N-13 ammonia                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9527  Iodine I-125 sodium iodide                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9528  Iodine I-131 iodide cap, dx                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9529  I131 iodide sol, dx                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9530  I131 iodide sol, rx                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9531  I131 max 100uCi                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9532  I125 serum albumin, dx                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9536  Tc99m depreotide                                  C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9537  Tc99m mebrofenin                                  C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9538  Tc99m pyrophosphate                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9539  Tc99m pentetate                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9540  Tc99m MAA                                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9541  Tc99m sulfur colloid                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9542  In111 ibritumomab, dx                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9543  Y90 ibritumomab, rx                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9544  I131 tositumomab, dx                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9545  I131 tositumomab, rx                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9546  Co57/58                                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9547  In111 oxyquinoline                                C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9548  In111 pentetate                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9550  Tc99m gluceptate                                  C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9551  Tc99m succimer                                    C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9552  F18 fdg                                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9553  Cr51 chromate                                     C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9554  I125 iothalamate, dx                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9555  Rb82 rubidium                                     C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9556  Ga67 gallium                                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9557  Tc99m bicisate                                    C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9558  Xe133 xenon 10mci                                 C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9559  Co57 cyano                                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9560  Tc99m labeled rbc                                 C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9561  Tc99m oxidronate                                  C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9562  Tc99m mertiatide                                  C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9563  P32 Na phosphate                                  C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9564  P32 chromic phosphate                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9566  Tc99m fanolesomab                                 C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9567  Technetium TC-99m aerosol                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9568  Technetium tc99m arcitumomab                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9569  Technetium TC-99m auto WBC                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9570  Indium In-111 auto WBC                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9571  Indium IN-111 auto platelet                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9572  Indium In-111 pentetreotide                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9576  Inj prohance multipack                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9577  Inj multihance                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9578  Inj multihance multipack                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9579  Gad-base MR contrast NOS,1ml                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9580  Sodium fluoride F-18                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9581  Gadoxetate disodium inj                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9582  Iodine I-123 iobenguane                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9583  Gadofosveset trisodium inj                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9600  Sr89 strontium                                    C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9604  Sm 153 lexidronam                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9698  Non-rad contrast materialNOC                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9699  Radiopharm rx agent noc                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
A9700  Echocardiography Contrast                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9900  Supply/accessory/service                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9901  Delivery/set up/dispensing                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
A9999  DME supply or accessory, nos                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0120  Periodic oral evaluation                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0140  Limit oral eval problm focus                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0145  Oral evaluation, pt < 3yrs                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0150  Comprehensve oral evaluation                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D0160  Extensv oral eval prob focus                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0170  Re-eval,est pt,problem focus                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0180  Comp periodontal evaluation                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0210  Intraor complete film series                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0220  Intraoral periapical first f                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0230  Intraoral periapical ea add                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0240  Intraoral occlusal film                           R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D0250  Extraoral first film                              R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D0260  Extraoral ea additional film                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D0270  Dental bitewing single film                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D0272  Dental bitewings two films                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D0273  Bitewings - three films                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0274  Dental bitewings four films                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D0277  Vert bitewings-sev to eight                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0290  Dental film skull/facial bon                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0310  Dental saliography                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0320  Dental tmj arthrogram incl i                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0321  Dental other tmj films                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0322  Dental tomographic survey                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0330  Dental panoramic film                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0340  Dental cephalometric film                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0350  Oral/facial photo images                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0360  Cone beam ct                                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0362  Cone beam, two dimensional                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0363  Cone beam, three dimensional                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0415  Collection of microorganisms                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0416  Viral culture                                     R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0417  Collect & prep saliva sample                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0418  Analysis of saliva sample                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0421  Gen tst suscept oral disease                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0425  Caries susceptibility test                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0431  Diag tst detect mucos abnorm                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0460  Pulp vitality test                                R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D0470  Diagnostic casts                                  N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0472  Gross exam, prep & report                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0473  Micro exam, prep & report                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0474  Micro w exam of surg margins                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0475  Decalcification procedure                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0476  Spec stains for microorganis                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0477  Spec stains not for microorg                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0478  Immunohistochemical stains                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0479  Tissue in-situ hybridization                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0480  Cytopath smear prep & report                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0481  Electron microscopy diagnost                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0482  Direct immunofluorescence                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0483  Indirect immunofluorescence                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0484  Consult slides prep elsewher                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0485  Consult inc prep of slides                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0486  Access of transep cytol samp                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D0502  Other oral pathology procedu                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D0999  Unspecified diagnostic proce                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D1110  Dental prophylaxis adult                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1120  Dental prophylaxis child                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1203  Topical app fluoride child                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1204  Topical app fluoride adult                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1206  Topical fluoride varnish                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1310  Nutri counsel-control caries                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1320  Tobacco counseling                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1330  Oral hygiene instruction                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1351  Dental sealant per tooth                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1352  Prev resin rest, perm tooth                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D1510  Space maintainer fxd unilat                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D1515  Fixed bilat space maintainer                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D1520  Remove unilat space maintain                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D1525  Remove bilat space maintain                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D1550  Recement space maintainer                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D1555  Remove fix space maintainer                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2140  Amalgam one surface permanen                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2150  Amalgam two surfaces permane                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2160  Amalgam three surfaces perma                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2161  Amalgam 4 or > surfaces perm                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2330  Resin one surface-anterior                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2331  Resin two surfaces-anterior                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2332  Resin three surfaces-anterio                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2335  Resin 4/> surf or w incis an                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2390  Ant resin-based cmpst crown                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2391  Post 1 srfc resinbased cmpst                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2392  Post 2 srfc resinbased cmpst                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2393  Post 3 srfc resinbased cmpst                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2394  Post >=4srfc resinbase cmpst                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2410  Dental gold foil one surface                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2420  Dental gold foil two surface                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2430  Dental gold foil three surfa                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2510  Dental inlay metalic 1 surf                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2520  Dental inlay metallic 2 surf                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2530  Dental inlay metl 3/more sur                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2542  Dental onlay metallic 2 surf                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2543  Dental onlay metallic 3 surf                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2544  Dental onlay metl 4/more sur                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2610  Inlay porcelain/ceramic 1 su                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2620  Inlay porcelain/ceramic 2 su                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2630  Dental onlay porc 3/more sur                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2642  Dental onlay porcelin 2 surf                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2643  Dental onlay porcelin 3 surf                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2644  Dental onlay porc 4/more sur                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2650  Inlay composite/resin one su                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2651  Inlay composite/resin two su                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2652  Dental inlay resin 3/mre sur                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2662  Dental onlay resin 2 surface                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2663  Dental onlay resin 3 surface                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2664  Dental onlay resin 4/mre sur                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2710  Crown resin-based indirect                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2712  Crown 3/4 resin-based compos                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2720  Crown resin w/ high noble me                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2721  Crown resin w/ base metal                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2722  Crown resin w/ noble metal                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2740  Crown porcelain/ceramic subs                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2750  Crown porcelain w/ h noble m                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2751  Crown porcelain fused base m                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2752  Crown porcelain w/ noble met                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2780  Crown 3/4 cast hi noble met                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2781  Crown 3/4 cast base metal                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2782  Crown 3/4 cast noble metal                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2783  Crown 3/4 porcelain/ceramic                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2790  Crown full cast high noble m                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2791  Crown full cast base metal                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2792  Crown full cast noble metal                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2794  Crown-titanium                                    N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2799  Provisional crown                                 N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2910  Recement inlay onlay or part                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2915  Recement cast or prefab post                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2920  Dental recement crown                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2930  Prefab stnlss steel crwn pri                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2931  Prefab stnlss steel crown pe                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2932  Prefabricated resin crown                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2933  Prefab stainless steel crown                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2934  Prefab steel crown primary                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2940  Protective restoration                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2950  Core build-up incl any pins                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2951  Tooth pin retention                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2952  Post and core cast + crown                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2953  Each addtnl cast post                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2954  Prefab post/core + crown                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2955  Post removal                                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2957  Each addtnl prefab post                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2960  Laminate labial veneer                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2961  Lab labial veneer resin                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2962  Lab labial veneer porcelain                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2970  Temp crown (fractured tooth)                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2971  Add proc construct new crown                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2975  Coping                                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2980  Crown repair                                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D2999  Dental unspec restorative pr                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D3110  Pulp cap direct                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3120  Pulp cap indirect                                 N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3220  Therapeutic pulpotomy                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3221  Gross pulpal debridement                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3222  Part pulp for apexogenesis                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3230  Pulpal therapy anterior prim                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3240  Pulpal therapy posterior pri                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3310  End thxpy, anterior tooth                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3320  End thxpy, bicuspid tooth                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3330  End thxpy, molar                                  N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3331  Non-surg tx root canal obs                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3332  Incomplete endodontic tx                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3333  Internal root repair                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3346  Retreat root canal anterior                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3347  Retreat root canal bicuspid                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3348  Retreat root canal molar                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3351  Apexification/recalc initial                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3352  Apexification/recalc interim                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3353  Apexification/recalc final                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3354  Pulpal regeneration                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3410  Apicoect/perirad surg anter                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3421  Root surgery bicuspid                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3425  Root surgery molar                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3426  Root surgery ea add root                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3430  Retrograde filling                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3450  Root amputation                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3460  Endodontic endosseous implan                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D3470  Intentional replantation                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3910  Isolation- tooth w rubb dam                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3920  Tooth splitting                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3950  Canal prep/fitting of dowel                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D3999  Endodontic procedure                              R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D4210  Gingivectomy/plasty per quad                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4211  Gingivectomy/plasty per toot                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4230  Ana crown exp 4 or> per quad                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4231  Ana crown exp 1-3 per quad                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4240  Gingival flap proc w/ planin                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4241  Gngvl flap w rootplan 1-3 th                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4245  Apically positioned flap                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4249  Crown lengthen hard tissue                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4260  Osseous surgery per quadrant                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D4261  Osseous surgl-3teethperquad                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4263  Bone replce graft first site                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D4264  Bone replce graft each add                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D4265  Bio mtrls to aid soft/os reg                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4266  Guided tiss regen resorble                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4267  Guided tiss regen nonresorb                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4268  Surgical revision procedure                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4270  Pedicle soft tissue graft pr                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D4271  Free soft tissue graft proc                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D4273  Subepithelial tissue graft                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D4274  Distal/proximal wedge proc                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4275  Soft tissue allograft                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4276  Con tissue w dble ped graft                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4320  Provision splnt intracoronal                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4321  Provisional splint extracoro                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4341  Periodontal scaling & root                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4342  Periodontal scaling 1-3teeth                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4355  Full mouth debridement                            R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D4381  Localized delivery antimicro                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D4910  Periodontal maint procedures                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4920  Unscheduled dressing change                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D4999  Unspecified periodontal proc                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5110  Dentures complete maxillary                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5120  Dentures complete mandible                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5130  Dentures immediat maxillary                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5140  Dentures immediat mandible                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5211  Dentures maxill part resin                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5212  Dentures mand part resin                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5213  Dentures maxill part metal                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5214  Dentures mandibl part metal                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5225  Maxillary part denture flex                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5226  Mandibular part denture flex                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5281  Removable partial denture                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5410  Dentures adjust cmplt maxil                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5411  Dentures adjust cmplt mand                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5421  Dentures adjust part maxill                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5422  Dentures adjust part mandbl                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5510  Dentur repr broken compl bas                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5520  Replace denture teeth complt                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5610  Dentures repair resin base                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5620  Rep part denture cast frame                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5630  Rep partial denture clasp                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5640  Replace part denture teeth                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5650  Add tooth to partial denture                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5660  Add clasp to partial denture                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5670  Replc tth&acrlc on mtl frmwk                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5671  Replc tth&acrlc mandibular                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5710  Dentures rebase cmplt maxil                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5711  Dentures rebase cmplt mand                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5720  Dentures rebase part maxill                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5721  Dentures rebase part mandbl                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5730  Denture reln cmplt maxil ch                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5731  Denture reln cmplt mand chr                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5740  Denture reln part maxil chr                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5741  Denture reln part mand chr                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5750  Denture reln cmplt max lab                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5751  Denture reln cmplt mand lab                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5760  Denture reln part maxil lab                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5761  Denture reln part mand lab                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5810  Denture interm cmplt maxill                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5811  Denture interm cmplt mandbl                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5820  Denture interm part maxill                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5821  Denture interm part mandbl                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5850  Denture tiss conditn maxill                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5851  Denture tiss condtin mandbl                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5860  Overdenture complete                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5861  Overdenture partial                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5862  Precision attachment                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5867  Replacement of precision att                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5875  Prosthesis modification                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5899  Removable prosthodontic proc                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5911  Facial moulage sectional                          R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D5912  Facial moulage complete                           R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D5913  Nasal prosthesis                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5914  Auricular prosthesis                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5915  Orbital prosthesis                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5916  Ocular prosthesis                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5919  Facial prosthesis                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5922  Nasal septal prosthesis                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5923  Ocular prosthesis interim                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5924  Cranial prosthesis                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5925  Facial augmentation implant                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5926  Replacement nasal prosthesis                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5927  Auricular replacement                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5928  Orbital replacement                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5929  Facial replacement                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5931  Surgical obturator                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5932  Postsurgical obturator                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5933  Refitting of obturator                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5934  Mandibular flange prosthesis                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5935  Mandibular denture prosth                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5936  Temp obturator prosthesis                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5937  Trismus appliance                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5951  Feeding aid                                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D5952  Pediatric speech aid                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5953  Adult speech aid                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5954  Superimposed prosthesis                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5955  Palatal lift prosthesis                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5958  Intraoral con def inter plt                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5959  Intraoral con def mod palat                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5960  Modify speech aid prosthesis                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5982  Surgical stent                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5983  Radiation applicator                              R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D5984  Radiation shield                                  R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D5985  Radiation cone locator                            R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D5986  Fluoride applicator                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5987  Commissure splint                                 R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D5988  Surgical splint                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5991  Topical medicament carrier                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5992  Adjust max prost appliance                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5993  Main/clean max prosthesis                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D5999  Maxillofacial prosthesis                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6010  Odontics endosteal implant                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6012  Endosteal implant                                 N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6040  Odontics eposteal implant                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6050  Odontics transosteal implnt                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6053  Implnt/abtmnt spprt remv dnt                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6054  Implnt/abtmnt spprt remvprtl                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6055  Implant connecting bar                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6056  Prefabricated abutment                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6057  Custom abutment                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6058  Abutment supported crown                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6059  Abutment supported mtl crown                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6060  Abutment supported mtl crown                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6061  Abutment supported mtl crown                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6062  Abutment supported mtl crown                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6063  Abutment supported mtl crown                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6064  Abutment supported mtl crown                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6065  Implant supported crown                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6066  Implant supported mtl crown                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6067  Implant supported mtl crown                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6068  Abutment supported retainer                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6069  Abutment supported retainer                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6070  Abutment supported retainer                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6071  Abutment supported retainer                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6072  Abutment supported retainer                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6073  Abutment supported retainer                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6074  Abutment supported retainer                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6075  Implant supported retainer                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6076  Implant supported retainer                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6077  Implant supported retainer                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6078  Implnt/abut suprtd fixd dent                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6079  Implnt/abut suprtd fixd dent                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6080  Implant maintenance                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6090  Repair implant                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6091  Repl semi/precision attach                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6092  Recement supp crown                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6093  Recement supp part denture                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6094  Abut support crown titanium                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6095  Odontics repr abutment                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6100  Removal of implant                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6190  Radio/surgical implant index                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6194  Abut support retainer titani                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6199  Implant procedure                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6205  Pontic-indirect resin based                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6210  Prosthodont high noble metal                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6211  Bridge base metal cast                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6212  Bridge noble metal cast                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6214  Pontic titanium                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6240  Bridge porcelain high noble                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6241  Bridge porcelain base metal                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6242  Bridge porcelain nobel metal                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6245  Bridge porcelain/ceramic                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6250  Bridge resin w/high noble                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6251  Bridge resin base metal                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6252  Bridge resin w/noble metal                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6253  Provisional pontic                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6254  Interim pontic                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6545  Dental retainr cast metl                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6548  Porcelain/ceramic retainer                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6600  Porcelain/ceramic inlay 2srf                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6601  Porc/ceram inlay >= 3 surfac                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6602  Cst hgh nble mtl inlay 2 srf                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6603  Cst hgh nble mtl inlay >=3sr                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6604  Cst bse mtl inlay 2 surfaces                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6605  Cst bse mtl inlay >= 3 surfa                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6606  Cast noble metal inlay 2 sur                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6607  Cst noble mtl inlay >=3 surf                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6608  Onlay porc/crmc 2 surfaces                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6609  Onlay porc/crmc >=3 surfaces                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6610  Onlay cst hgh nbl mtl 2 srfc                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6611  Onlay cst hgh nbl mtl >=3srf                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6612  Onlay cst base mtl 2 surface                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6613  Onlay cst base mtl >=3 surfa                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6614  Onlay cst nbl mtl 2 surfaces                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6615  Onlay cst nbl mtl >=3 surfac                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6624  Inlay titanium                                    N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6634  Onlay titanium                                    N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6710  Crown-indirect resin based                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6720  Retain crown resin w hi nble                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6721  Crown resin w/base metal                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6722  Crown resin w/noble metal                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6740  Crown porcelain/ceramic                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6750  Crown porcelain high noble                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6751  Crown porcelain base metal                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6752  Crown porcelain noble metal                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6780  Crown 3/4 high noble metal                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6781  Crown 3/4 cast based metal                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6782  Crown 3/4 cast noble metal                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6783  Crown 3/4 porcelain/ceramic                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6790  Crown full high noble metal                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6791  Crown full base metal cast                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6792  Crown full noble metal cast                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6793  Provisional retainer crown                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6794  Crown titanium                                    N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6795  Interim retainer crown                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6920  Dental connector bar                              R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D6930  Dental recement bridge                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6940  Stress breaker                                    N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6950  Precision attachment                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6970  Post & core plus retainer                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6972  Prefab post & core plus reta                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6973  Core build up for retainer                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6975  Coping metal                                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6976  Each addtnl cast post                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6977  Each addtl prefab post                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6980  Bridge repair                                     N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6985  Pediatric partial denture fx                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D6999  Fixed prosthodontic proc                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7111  Extraction coronal remnants                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7140  Extraction erupted tooth/exr                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7210  Rem imp tooth w mucoper flp                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D7220  Impact tooth remov soft tiss                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D7230  Impact tooth remov part bony                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D7240  Impact tooth remov comp bony                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D7241  Impact tooth rem bony w/comp                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D7250  Tooth root removal                                R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D7251  Coronectomy                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7260  Oral antral fistula closure                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D7261  Primary closure sinus perf                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7270  Tooth reimplantation                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7272  Tooth transplantation                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7280  Exposure impact tooth orthod                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7282  Mobilize erupted/malpos toot                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7283  Place device impacted tooth                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7285  Biopsy of oral tissue hard                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7286  Biopsy of oral tissue soft                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7287  Exfoliative cytolog collect                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7288  Brush biopsy                                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7290  Repositioning of teeth                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7291  Transseptal fiberotomy                            R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D7292  Screw retained plate                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7293  Temp anchorage dev w flap                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7294  Temp anchorage dev w/o flap                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7295  Bone harvest,auto graft proc                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7310  Alveoplasty w/ extraction                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7311  Alveoloplasty w/extract 1-3                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7320  Alveoplasty w/o extraction                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7321  Alveoloplasty not w/extracts                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7340  Vestibuloplasty ridge extens                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7350  Vestibuloplasty exten graft                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7410  Rad exc lesion up to 1.25 cm                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7411  Excision benign lesion>1.25c                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7412  Excision benign lesion compl                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7413  Excision malig lesion<=1.25c                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7414  Excision malig lesion>1.25cm                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7415  Excision malig les complicat                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7440  Malig tumor exc to 1.25 cm                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7441  Malig tumor > 1.25 cm                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7450  Rem odontogen cyst to 1.25cm                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7451  Rem odontogen cyst > 1.25 cm                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7460  Rem nonodonto cyst to 1.25cm                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7461  Rem nonodonto cyst > 1.25 cm                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7465  Lesion destruction                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7471  Rem exostosis any site                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7472  Removal of torus palatinus                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7473  Remove torus mandibularis                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7485  Surg reduct osseoustuberosit                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7490  Maxilla or mandible resectio                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7510  I&d absc intraoral soft tiss                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7511  Incision/drain abscess intra                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7520  I&d abscess extraoral                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7521  Incision/drain abscess extra                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7530  Removal fb skin/areolar tiss                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7540  Removal of fb reaction                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7550  Removal of sloughed off bone                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7560  Maxillary sinusotomy                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7610  Maxilla open reduct simple                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7620  Clsd reduct simpl maxilla fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7630  Open red simpl mandible fx                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7640  Clsd red simpl mandible fx                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7650  Open red simp malar/zygom fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7660  Clsd red simp malar/zygom fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7670  Closd rductn splint alveolus                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7671  Alveolus open reduction                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7680  Reduct simple facial bone fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7710  Maxilla open reduct compound                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7720  Clsd reduct compd maxilla fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7730  Open reduct compd mandble fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7740  Clsd reduct compd mandble fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7750  Open red comp malar/zygma fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7760  Clsd red comp malar/zygma fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7770  Open reduc compd alveolus fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7771  Alveolus clsd reduc stblz te                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7780  Reduct compnd facial bone fx                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7810  Tmj open reduct-dislocation                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7820  Closed tmp manipulation                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7830  Tmj manipulation under anest                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7840  Removal of tmj condyle                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7850  Tmj meniscectomy                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7852  Tmj repair of joint disc                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7854  Tmj excisn of joint membrane                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7856  Tmj cutting of a muscle                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7858  Tmj reconstruction                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7860  Tmj cutting into joint                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7865  Tmj reshaping components                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7870  Tmj aspiration joint fluid                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7871  Lysis + lavage w catheters                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7872  Tmj diagnostic arthroscopy                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7873  Tmj arthroscopy lysis adhesn                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7874  Tmj arthroscopy disc reposit                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7875  Tmj arthroscopy synovectomy                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7876  Tmj arthroscopy discectomy                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7877  Tmj arthroscopy debridement                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7880  Occlusal orthotic appliance                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7899  Tmj unspecified therapy                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7910  Dent sutur recent wnd to 5cm                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7911  Dental suture wound to 5 cm                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7912  Suture complicate wnd > 5 cm                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7920  Dental skin graft                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7940  Reshaping bone orthognathic                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D7941  Bone cutting ramus closed                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7943  Cutting ramus open w/graft                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7944  Bone cutting segmented                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7945  Bone cutting body mandible                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7946  Reconstruction maxilla total                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7947  Reconstruct maxilla segment                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7948  Reconstruct midface no graft                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7949  Reconstruct midface w/graft                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7950  Mandible graft                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7951  Sinus aug w bone/bone sup                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7953  Bone replacement graft                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7955  Repair maxillofacial defects                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7960  Frenulectomy/frenectomy                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7963  Frenuloplasty                                     N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7970  Excision hyperplastic tissue                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7971  Excision pericoronal gingiva                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7972  Surg redct fibrous tuberosit                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7980  Sialolithotomy                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7981  Excision of salivary gland                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7982  Sialodochoplasty                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7983  Closure of salivary fistula                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7990  Emergency tracheotomy                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7991  Dental coronoidectomy                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7995  Synthetic graft facial bones                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7996  Implant mandible for augment                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7997  Appliance removal                                 N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7998  Intraoral place of fix dev                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D7999  Oral surgery procedure                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8010  Limited dental tx primary                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8020  Limited dental tx transition                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8030  Limited dental tx adolescent                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8040  Limited dental tx adult                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8050  Intercep dental tx primary                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8060  Intercep dental tx transitn                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8070  Compre dental tx transition                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8080  Compre dental tx adolescent                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8090  Compre dental tx adult                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8210  Orthodontic rem appliance tx                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8220  Fixed appliance therapy habt                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8660  Preorthodontic tx visit                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8670  Periodic orthodontc tx visit                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8680  Orthodontic retention                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8690  Orthodontic treatment                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8691  Repair ortho appliance                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8692  Replacement retainer                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8693  Rebond/cement/repair retain                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D8999  Orthodontic procedure                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9110  Tx dental pain minor proc                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D9120  Fix partial denture section                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9210  Dent anesthesia w/o surgery                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9211  Regional block anesthesia                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9212  Trigeminal block anesthesia                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9215  Local anesthesia                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9220  General anesthesia                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9221  General anesthesia ea ad 15m                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9230  Analgesia                                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D9241  Intravenous sedation                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9242  IV sedation ea ad 30 m                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9248  Sedation (non-iv)                                 R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9310  Dental consultation                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9410  Dental house call                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9420  Hospital/ASC call                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9430  Office visit during hours                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9440  Office visit after hours                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9450  Case presentation tx plan                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9610  Dent therapeutic drug inject                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9612  Thera par drugs 2 or > admin                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9630  Other drugs/medicaments                           R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D9910  Dent appl desensitizing med                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9911  Appl desensitizing resin                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9920  Behavior management                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9930  Treatment of complications                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D9940  Dental occlusal guard                             R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D9941  Fabrication athletic guard                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9942  Repair/reline occlusal guard                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9950  Occlusion analysis                                R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D9951  Limited occlusal adjustment                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D9952  Complete occlusal adjustment                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
D9970  Enamel microabrasion                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9971  Odontoplasty 1-2 teeth                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9972  Extrnl bleaching per arch                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9973  Extrnl bleaching per tooth                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9974  Intrnl bleaching per tooth                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
D9999  Adjunctive procedure                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0008  Admin influenza virus vac                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0009  Admin pneumococcal vaccine                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0010  Admin hepatitis b vaccine                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0027  Semen analysis                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0101  CA screen;pelvic/breast exam                      A   0.45   0.61     0.61     0.32     0.32     0.03   1.09   1.09   0.80   0.80  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0102  Prostate ca screening; dre                        A   0.17   0.39     0.37     0.08     0.08     0.01   0.57   0.55   0.26   0.26  0XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0103  PSA screening                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0104  CA screen;flexi sigmoidscope                      A   0.96   2.96     2.93     0.77     0.80     0.14   4.06   4.03   1.87   1.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
G0105  Colorectal scrn; hi risk ind                      A   3.69   7.41     7.15     2.23     2.27     0.58  11.68  11.42   6.50   6.54  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
G010553Colorectal scrn; hi risk ind                      A   0.96   2.96     2.93     0.77     0.80     0.14   4.06   4.03   1.87   1.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
G0106  Colon CA screen;barium enema                      A   0.99   5.25     5.18     5.25NA   5.18 NA  0.04   6.28   6.21   6.28   6.21  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0106TCColon CA screen;barium enema                      A   0.00   4.84     4.81     4.84NA   4.81 NA  0.01   4.85   4.82   4.85   4.82  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
G010626Colon CA screen;barium enema                      A   0.99   0.41     0.37     0.41     0.37     0.03   1.43   1.39   1.43   1.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0108  Diab manage trn  per indiv                        A   0.90   0.66     0.55     0.66NA   0.55 NA  0.05   1.61   1.50   1.61   1.50  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0109  Diab manage trn ind/group                         A   0.25   0.29     0.15     0.29NA   0.15 NA  0.01   0.55   0.41   0.55   0.41  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0117  Glaucoma scrn hgh risk direc                      T   0.45   0.98     1.03     0.98NA   1.03 NA  0.03   1.46   1.51   1.46   1.51  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0118  Glaucoma scrn hgh risk direc                      T   0.17   0.83     0.87     0.83NA   0.87 NA  0.01   1.01   1.05   1.01   1.05  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0120  Colon ca scrn; barium enema                       A   0.99   5.25     5.18     5.25NA   5.18 NA  0.04   6.28   6.21   6.28   6.21  1XXX.00.00.0000000             25.5217 090 99      3.75   3.75   0.04
G0120TCColon ca scrn; barium enema                       A   0.00   4.84     4.81     4.84NA   4.81 NA  0.01   4.85   4.82   4.85   4.82  1XXX.00.00.0000000             25.5217 090 99      3.34   3.34   0.01
G012026Colon ca scrn; barium enema                       A   0.99   0.41     0.37     0.41     0.37     0.03   1.43   1.39   1.43   1.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0121  Colon ca scrn not hi rsk ind                      A   3.69   7.41     7.15     2.23     2.27     0.58  11.68  11.42   6.50   6.54  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
G012153Colon ca scrn not hi rsk ind                      A   0.96   2.96     2.93     0.77     0.80     0.14   4.06   4.03   1.87   1.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
G0122  Colon ca scrn; barium enema                       N+  0.99   6.90     7.18     6.90NA   7.18 NA  0.05   7.94   8.22   7.94   8.22  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0122TCColon ca scrn; barium enema                       N+  0.00   6.47     6.74     6.47NA   6.74 NA  0.01   6.48   6.75   6.48   6.75  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G012226Colon ca scrn; barium enema                       N+  0.99   0.43     0.44     0.43     0.44     0.04   1.46   1.47   1.46   1.47  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0123  Screen cerv/vag thin layer                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0124  Screen c/v thin layer by MD                       A   0.42   0.40     0.42     0.40     0.42     0.03   0.85   0.87   0.85   0.87  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0127  Trim nail(s)                                      R   0.17   0.45     0.48     0.06     0.05     0.01   0.63   0.66   0.24   0.23  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
G0128  CORF skilled nursing service                      R   0.08   0.19     0.20     0.19NA   0.20 NA  0.01   0.28   0.29   0.28   0.29  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0130  Single energy x-ray study                         A   0.22   0.74     0.72     0.74NA   0.72 NA  0.02   0.98   0.96   0.98   0.96  1XXX.00.00.0000000             25.5217 090 99      1.83   1.83   0.04
G0130TCSingle energy x-ray study                         A   0.00   0.65     0.62     0.65NA   0.62 NA  0.01   0.66   0.63   0.66   0.63  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
G013026Single energy x-ray study                         A   0.22   0.09     0.10     0.09     0.10     0.01   0.32   0.33   0.32   0.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0141  Scr c/v cyto,autosys and md                       A   0.42   0.40     0.42     0.40     0.42     0.03   0.85   0.87   0.85   0.87  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0143  Scr c/v cyto,thinlayer,rescr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0144  Scr c/v cyto,thinlayer,rescr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0145  Scr c/v cyto,thinlayer,rescr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0147  Scr c/v cyto, automated sys                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0148  Scr c/v cyto, autosys, rescr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0157  HHC PT assistant ea 15                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0158  HHC OT assistant ea 15                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0159  HHC PT maint ea 15 min                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0160  HHC Occup Therapy ea 15                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0161  HHC SLP ea 15 min                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0162  HHC RN E&M plan svs, 15 min                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0163  HHC LPN/RN obs/asses ea 15                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0164  HHC lis nurse train ea 15                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0166  Extrnl counterpulse, per tx                       A   0.07   4.43     3.86     4.43NA   3.86 NA  0.03   4.53   3.96   4.53   3.96  0XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0168  Wound closure by adhesive                         A   0.45   2.07     2.14     0.28     0.30     0.03   2.55   2.62   0.76   0.78  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
G0173  Linear acc stereo radsur com                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0175  OPPS Service,sched team conf                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0176  OPPS/PHP;activity therapy                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0177  OPPS/PHP; train & educ serv                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0179  MD recertification HHA PT                         A   0.45   0.72     0.68     0.72NA   0.68 NA  0.03   1.20   1.16   1.20   1.16  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0180  MD certification HHA patient                      A   0.67   0.85     0.80     0.85NA   0.80 NA  0.04   1.56   1.51   1.56   1.51  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0181  Home health care supervision                      A   1.73   1.24     1.28     1.24NA   1.28 NA  0.10   3.07   3.11   3.07   3.11  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0182  Hospice care supervision                          A   1.73   1.28     1.29     1.28NA   1.29 NA  0.10   3.11   3.12   3.11   3.12  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0186  Dstry eye lesn,fdr vssl tech                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
G0202  Screeningmammographydigital                       A   0.70   3.39     3.34     3.39NA   3.34 NA  0.05   4.14   4.09   4.14   4.09  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
G0202TCScreeningmammographydigital                       A   0.00   3.10     3.06     3.10NA   3.06 NA  0.01   3.11   3.07   3.11   3.07  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
G020226Screeningmammographydigital                       A   0.70   0.29     0.28     0.29     0.28     0.04   1.03   1.02   1.03   1.02  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
G0204  Diagnosticmammographydigital                      A   0.87   4.03     4.06     4.03NA   4.06 NA  0.06   4.96   4.99   4.96   4.99  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
G0204TCDiagnosticmammographydigital                      A   0.00   3.67     3.70     3.67NA   3.70 NA  0.01   3.68   3.71   3.68   3.71  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
G020426Diagnosticmammographydigital                      A   0.87   0.36     0.36     0.36     0.36     0.05   1.28   1.28   1.28   1.28  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
G0206  Diagnosticmammographydigital                      A   0.70   3.17     3.18     3.17NA   3.18 NA  0.05   3.92   3.93   3.92   3.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0206TCDiagnosticmammographydigital                      A   0.00   2.88     2.90     2.88NA   2.90 NA  0.01   2.89   2.91   2.89   2.91  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G020626Diagnosticmammographydigital                      A   0.70   0.29     0.28     0.29     0.28     0.04   1.03   1.02   1.03   1.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0219  PET img wholbod melano nonco                      N   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0219TCPET img wholbod melano nonco                      N   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
G021926PET img wholbod melano nonco                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0235  PET not otherwise specified                       N   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0235TCPET not otherwise specified                       N   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
G023526PET not otherwise specified                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0237  Therapeutic procd strg endur                      A   0.00   0.29     0.25     0.29NA   0.25 NA  0.01   0.30   0.26   0.30   0.26  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0238  Oth resp proc, indiv                              A   0.00   0.31     0.26     0.31NA   0.26 NA  0.01   0.32   0.27   0.32   0.27  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0239  Oth resp proc, group                              A   0.00   0.34     0.31     0.34NA   0.31 NA  0.01   0.35   0.32   0.35   0.32  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0245  Initial foot exam pt lops                         R   0.88   1.09     1.16     0.44     0.49     0.05   2.02   2.09   1.37   1.42  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0246  Followup eval of foot pt lop                      R   0.45   0.70     0.73     0.22     0.24     0.03   1.18   1.21   0.70   0.72  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0247  Routine footcare pt w lops                        R   0.50   1.17     1.56     0.18     0.15     0.04   1.71   2.10   0.72   0.69  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0248  Demonstrate use home inr mon                      R   0.00   4.13     3.23     4.13NA   3.23 NA  0.01   4.14   3.24   4.14   3.24  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
G0249  Provide INR test mater/equip                      R   0.00   3.65     3.02     3.65NA   3.02 NA  0.01   3.66   3.03   3.66   3.03  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
G0250  MD INR test revie inter mgmt                      R   0.18   0.08     0.07     0.08NA   0.07 NA  0.01   0.27   0.26   0.27   0.26  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0251  Linear acc based stero radio                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0252  PET imaging initial dx                            N   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0252TCPET imaging initial dx                            N   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G025226PET imaging initial dx                            N+  1.50   0.70     0.66     0.70     0.66     0.10   2.30   2.26   2.30   2.26  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0255  Current percep threshold tst                      N   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0255TCCurrent percep threshold tst                      N   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
G025526Current percep threshold tst                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0257  Unsched dialysis ESRD pt hos                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0259  Inject for sacroiliac joint                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0260  Inj for sacroiliac jt anesth                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0268  Removal of impacted wax md                        A   0.61   0.86     0.91     0.31     0.36     0.03   1.50   1.55   0.95   1.00  0000.00.00.0022100             25.5217 090 99      0.00   0.00   0.00
G0269  Occlusive device in vein art                      B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0270  MNT subs tx for change dx                         A   0.45   0.34     0.37     0.28     0.31     0.03   0.82   0.85   0.76   0.79  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0271  Group MNT 2 or more 30 mins                       A   0.25   0.15     0.18     0.15     0.17     0.01   0.41   0.44   0.41   0.43  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0275  Renal angio, cardiac cath                         A   0.25   0.13NA   0.10NA   0.13     0.10     0.01   0.39   0.36   0.39   0.36  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0278  Iliac art angio,cardiac cath                      A   0.25   0.13NA   0.10NA   0.13     0.10     0.01   0.39   0.36   0.39   0.36  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0281  Elec stim unattend for press                      A   0.18   0.18     0.20     0.18NA   0.20 NA  0.01   0.37   0.39   0.37   0.39  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
G0282  Elect stim wound care not pd                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0283  Elec stim other than wound                        A   0.18   0.18     0.20     0.18NA   0.20 NA  0.01   0.37   0.39   0.37   0.39  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
G0288  Recon, CTA for surg plan                          A   0.00   2.56     1.00     2.56NA   1.00 NA  0.01   2.57   1.01   2.57   1.01  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
G0289  Arthro, loose body + chondro                      A   1.48   0.85NA   0.88NA   0.85     0.88     0.29   2.62   2.65   2.62   2.65  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
G0290  Drug-eluting stents, single                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0291  Drug-eluting stents,each add                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0293  Non-cov surg proc,clin trial                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0294  Non-cov proc, clinical trial                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0295  Electromagnetic therapy onc                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0302  Pre-op service LVRS complete                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0303  Pre-op service LVRS 10-15dos                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0304  Pre-op service LVRS 1-9 dos                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0305  Post op service LVRS min 6                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0306  CBC/diffwbc w/o platelet                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0307  CBC without platelet                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0328  Fecal blood scrn immunoassay                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0329  Electromagntic tx for ulcers                      A   0.06   0.20     0.22     0.20NA   0.22 NA  0.01   0.27   0.29   0.27   0.29  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
G0333  Dispense fee initial 30 day                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0337  Hospice evaluation preelecti                      X+  1.42   0.63     0.63     0.63     0.63     0.10   2.15   2.15   2.15   2.15  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0339  Robot lin-radsurg com, first                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0340  Robt lin-radsurg fractx 2-5                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0341  Percutaneous islet celltrans                      A   6.98  29.60    53.67     3.85     3.01     0.49  37.07  61.14  11.32  10.48  0000.00.00.0020010             25.5217 090 99      0.00   0.00   0.00
G0342  Laparoscopy islet cell trans                      A  11.92   7.17NA   7.86NA   7.17     7.86     0.84  19.93  20.62  19.93  20.62  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
G0343  Laparotomy islet cell transp                      A  19.85  12.14NA  13.34NA  12.14    13.34     1.40  33.39  34.59  33.39  34.59  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
G0364  Bone marrow aspirate &biopsy                      A   0.16   0.19     0.19     0.09     0.09     0.01   0.36   0.36   0.26   0.26  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0365  Vessel mapping hemo access                        A   0.25   5.92     5.89     5.92NA   5.89 NA  0.04   6.21   6.18   6.21   6.18  1XXX.00.00.0000000             25.5217 090 99      6.07   6.07   0.04
G0365TCVessel mapping hemo access                        A   0.00   5.83     5.80     5.83NA   5.80 NA  0.01   5.84   5.81   5.84   5.81  1XXX.00.00.0000000             25.5217 010 99      5.98   5.98   0.01
G036526Vessel mapping hemo access                        A   0.25   0.09     0.09     0.09     0.09     0.03   0.37   0.37   0.37   0.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0372  MD service required for PMD                       A   0.17   0.12     0.08     0.07     0.08     0.01   0.30   0.26   0.25   0.26  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0378  Hospital observation per hr                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0379  Direct refer hospital observ                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0389  Ultrasound exam AAA screen                        A   0.58   2.69     2.46     2.69NA   2.46 NA  0.04   3.31   3.08   3.31   3.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0389TCUltrasound exam AAA screen                        A   0.00   2.44     2.24     2.44NA   2.24 NA  0.01   2.45   2.25   2.45   2.25  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
G038926Ultrasound exam AAA screen                        A   0.58   0.25     0.22     0.25     0.22     0.03   0.86   0.83   0.86   0.83  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0396  Alcohol/subs interv 15-30mn                       A   0.65   0.29     0.32     0.23     0.27     0.04   0.98   1.01   0.92   0.96  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0397  Alcohol/subs interv >30 min                       A   1.30   0.62     0.79     0.56     0.74     0.08   2.00   2.17   1.94   2.12  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0398  Home sleep test/type 2 Porta                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0398TCHome sleep test/type 2 Porta                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G039826Home sleep test/type 2 Porta                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0399  Home sleep test/type 3 Porta                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0399TCHome sleep test/type 3 Porta                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G039926Home sleep test/type 3 Porta                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0400  Home sleep test/type 4 Porta                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0400TCHome sleep test/type 4 Porta                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G040026Home sleep test/type 4 Porta                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0402  Initial preventive exam                           A   2.43   1.80     2.20     1.15     1.15     0.12   4.35   4.75   3.70   3.70  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0403  EKG for initial prevent exam                      A   0.17   0.40     0.32     0.39NA   0.32 NA  0.02   0.59   0.51   0.58   0.51  4XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0404  EKG tracing for initial prev                      A   0.00   0.32     0.25     0.32NA   0.25 NA  0.01   0.33   0.26   0.33   0.26  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0405  EKG interpret & report preve                      A   0.17   0.08     0.07     0.07     0.07     0.01   0.26   0.25   0.25   0.25  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0406  Telhealth inpt consult 15min                      A   0.76   0.32NA   0.34NA   0.32     0.34     0.05   1.13   1.15   1.13   1.15  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0407  Telheath inpt consult 25min                       A   1.39   0.58NA   0.64NA   0.58     0.64     0.08   2.05   2.11   2.05   2.11  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0408  Telhealth inpt consult 35min                      A   2.00   0.82NA   0.90NA   0.82     0.90     0.12   2.94   3.02   2.94   3.02  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0409  CORF related serv 15 mins ea                      A   0.00   0.29     0.29     0.29NA   0.29 NA  0.01   0.30   0.30   0.30   0.30  9XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0410  Grp psych partial hosp 45-50                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0411  Inter active grp psych parti                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0412  Open tx iliac spine uni/bil                       A  10.45   8.76NA   9.26NA   8.76     9.26     2.04  21.25  21.75  21.25  21.75  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
G0413  Pelvic ring fracture uni/bil                      A  15.73  12.27NA  12.80NA  12.27    12.80     3.06  31.06  31.59  31.06  31.59  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
G0414  Pelvic ring fx treat int fix                      A  14.65  12.05NA  12.64NA  12.05    12.64     2.85  29.55  30.14  29.55  30.14  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
G0415  Open tx post pelvic fxcture                       A  20.93  15.41NA  16.42NA  15.41    16.42     4.20  40.54  41.55  40.54  41.55  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
G0416  Sat biopsy prostate 1-20 spc                      A   3.09  13.96    13.96    13.96NA  13.96 NA  0.12  17.17  17.17  17.17  17.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0416TCSat biopsy prostate 1-20 spc                      A   0.00  12.14    12.14    12.14NA  12.14 NA  0.01  12.15  12.15  12.15  12.15  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G041626Sat biopsy prostate 1-20 spc                      A   3.09   1.82     1.82     1.82     1.82     0.11   5.02   5.02   5.02   5.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0417  Sat biopsy prostate 21-40                         A   5.86  27.26    27.26    27.26NA  27.26 NA  0.25  33.37  33.37  33.37  33.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0417TCSat biopsy prostate 21-40                         A   0.00  23.71    23.71    23.71NA  23.71 NA  0.01  23.72  23.72  23.72  23.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G041726Sat biopsy prostate 21-40                         A   5.86   3.55     3.55     3.55     3.55     0.24   9.65   9.65   9.65   9.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0418  Sat biopsy prostate 41-60                         A  10.30  46.56    46.56    46.56NA  46.56 NA  0.42  57.28  57.28  57.28  57.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0418TCSat biopsy prostate 41-60                         A   0.00  40.50    40.50    40.50NA  40.50 NA  0.01  40.51  40.51  40.51  40.51  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G041826Sat biopsy prostate 41-60                         A  10.30   6.06     6.06     6.06     6.06     0.41  16.77  16.77  16.77  16.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0419  Sat biopsy prostate: >60                          A  11.61  55.86    55.86    55.86NA  55.86 NA  0.46  67.93  67.93  67.93  67.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0419TCSat biopsy prostate: >60                          A   0.00  48.60    48.60    48.60NA  48.60 NA  0.01  48.61  48.61  48.61  48.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G041926Sat biopsy prostate: >60                          A  11.61   7.26     7.26     7.26     7.26     0.45  19.32  19.32  19.32  19.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0420  Ed svc CKD ind per session                        A   2.12   1.03     1.03     1.03NA   1.03 NA  0.11   3.26   3.26   3.26   3.26  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0421  Ed svc CKD grp per session                        A   0.50   0.24     0.24     0.24NA   0.24 NA  0.03   0.77   0.77   0.77   0.77  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0422  Intens cardiac rehab w/exerc                      A   1.41   1.21     1.21     1.21     1.21     0.08   2.70   2.70   2.70   2.70  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0423  Intens cardiac rehab no exer                      A   1.41   1.21     1.21     1.21     1.21     0.08   2.70   2.70   2.70   2.70  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0424  Pulmonary rehab w exer                            A   0.28   0.59     0.59     0.12     0.12     0.03   0.90   0.90   0.43   0.43  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0425  Inpt telehealth consult 30m                       A   1.92   0.86NA   0.86NA   0.86     0.86     0.18   2.96   2.96   2.96   2.96  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0426  Inpt telehealth consult 50m                       A   2.61   1.21NA   1.21NA   1.21     1.21     0.22   4.04   4.04   4.04   4.04  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0427  Inpt telehealth con 70/>m                         A   3.86   1.78NA   1.78NA   1.78     1.78     0.29   5.93   5.93   5.93   5.93  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0428  Collagen Meniscus Implant                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0429  Dermal filler injection(s)                        A   1.19   1.19     1.19     0.56     0.56     0.24   2.62   2.62   1.99   1.99  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
G0431  Drug screen multip class                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0432  EIA HIV-1/HIV-2 screen                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0433  ELISA HIV-1/HIV-2 screen                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0434  Drug screen multi drug class                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0435  Oral HIV-1/HIV-2 screen                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G0436  Tobacco-use counsel 3-10 min                      A   0.24   0.16     0.16     0.10     0.10     0.01   0.41   0.41   0.35   0.35  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0437  Tobacco-use counsel>10min                         A   0.50   0.30     0.30     0.24     0.24     0.03   0.83   0.83   0.77   0.77  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0438  PPPS, initial visit                               A   2.43   2.19     2.19     2.19NA   2.19 NA  0.12   4.74   4.74   4.74   4.74  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0439  PPPS, subseq visit                                A   1.50   1.63     1.63     1.63NA   1.63 NA  0.03   3.16   3.16   3.16   3.16  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G0440  Skin/dermal subs init 25or<                       A   2.22   2.72     2.72     1.02     1.02     0.27   5.21   5.21   3.51   3.51  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
G0441  Skin/dermal subs each additi                      A   0.50   0.82     0.82     0.20     0.20     0.07   1.39   1.39   0.77   0.77  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G3001  Admin + supply, tositumomab                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8126  Pt treat w/antidepress12wks                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8127  Pt not treat w/antidepres12w                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8128  Pt inelig for antidepres med                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8395  LVEF>=40% doc normal or mild                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8396  LVEF not performed                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8397  Dil macula/fundus exam/w doc                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8398  Dil macular/fundus not perfo                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8399  Pt w/DXA document or order                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8400  Pt w/DXA no document or orde                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8401  Pt inelig osteo screen measu                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8404  Low extemity neur exam docum                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8405  Low extemity neur not perfor                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8406  Pt inelig lower extrem neuro                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8410  Eval on foot documented                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8415  Eval on foot not performed                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8416  Pt inelig footwear evaluatio                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8417  Calc BMI abv up param f/u                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8418  Calc BMI blw low param f/u                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8419  Calc BMI out nrm param nof/u                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8420  Calc BMI norm parameters                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8421  BMI not calculated                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8422  Pt inelig BMI calculation                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8427  Doc cur meds by prov                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8428  Cur meds not document                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8430  Pt inelig med check                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8431  Pos clin depres scrn f/u doc                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8432  Clin depression screen not d                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8433  Pt inelig; scrn clin dep                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8440  Pain assess f/u pln document                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8441  No document of pain assess                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8442  Pt inelig pain assessment                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8447  Pt vis doc use EHR cer ATCB                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8448  Pt vis doc w/PQRI qual EHR                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8450  Beta-bloc rx pt w/abn lvef                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8451  Pt w/abn lvef inelig b-bloc                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8452  Pt w/abn lvef b-bloc no rx                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8458  Pt inelig geno no antvir tx                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8459  Doc pt rec antivir treat                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8460  Pt inelig RNA no antvir tx                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8461  Pt rec antivir treat hep c                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8462  Pt inelig couns no antvir tx                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8463  Pt rec antiviral treat doc                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8464  Pt inelig; lo to no dter rsk                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8465  High risk recurrence pro ca                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8468  ACE/ARB rx pt w/abn lvef                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8469  Pt w/abn lvef inelig ACE/ARB                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8470  Pt w/ normal lvef                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8471  LVEF not performed/doc                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8472  ACE/ARB no rx pt w/abn lvef                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8473  ACE/ARB thxpy rx'd                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8474  ACE/ARB not rx'd; doc reas                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8475  ACE/ARB thxpy not rx'd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8476  BP sys <130 and dias <80                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8477  BP sys>=130 and/or dias >=80                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8478  BP not performed/doc                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8482  Flu immunize order/admin                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8483  Flu imm no ord/admin doc rea                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8484  Flu immunize no order/admin                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8485  Report, Diabetes measures                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8486  Report, Prev Care Measures                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8487  Report CKD Measures                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8489  CAD measures grp                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8490  RA measures grp                                   M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8491  HIV/AIDS measures grp                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8492  Periop Care measures grp                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8493  Back pain measures grp                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8494  DM meas qual act perform                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8495  CKD meas qual act perform                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8496  Prev Care MG qual act perfrm                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8497  CABG meas qual act perform                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8498  CAD meas qual act perform                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8499  RA meas qual act perform                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8500  HIV meas qual act perform                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8501  Perio meas qual act perform                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8502  Back Pain MG qual act perfrm                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8506  Pt rec ACE/ARB                                    M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8508  Pt inelig; pain asses no f/u                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8509  Pain assess no f/u pln doc                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8510  Pt inelig neg scrn depres                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8511  Clin depres scrn no f/u doc                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8524  Patch closure conv CEA                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8525  No patch closure CEA                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8526  No patch closure conv CEA                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8530  Auto AV fistula recd                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8531  Pt inelig; auto AV fistula                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8532  No auto AV fistula; no reas                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8534  Doc elder mal scrn f/u plan                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8535  Pt inelig no eld mal scrn                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8536  No doc elder mal scrn                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8537  Pt inelig eldmal scrn no f/u                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8538  Eld mal scrn no f/u pln                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8539  Cur funct assess & care pln                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8540  Pt inelig funct assess                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8541  No doc cur funct assess                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8542  Pt inelig func asses no pln                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8543  Cur funct asses; no care pln                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8544  CABG measures grp                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8545  HepC measures grp                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8546  CAP measures grp                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8547  IVD measures grp                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8548  HF measures grp                                   M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8549  HepC MG qual act perform                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8550  CAP MG qual act perform                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8551  HF MG qual act perform                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8552  IVD MG qual act perform                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8553  1 Rx via qualified eRx sys                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8556  Ref to doc otolog eval                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8557  Pt inelig ref otolog eval                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8558  No ref to doc otolog eval                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8559  Pt ref doc oto eval                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8560  Pt hx act drain prev 90 days                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8561  Pt inelig for ref oto eval                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8562  Pt no hx act drain 90 d                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8563  Pt no ref oto reas no spec                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8564  Pt ref oto eval                                   M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8565  Ver doc hear loss                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8566  Pt inelig ref oto eval                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8567  Pt no doc hear loss                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8568  Pt no ref otolo no spec                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8569  Prol intubation req                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8570  No prol intub req                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8571  Ster wd ifx 30 d postop                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8572  No ster wd ifx                                    M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8573  Stk/CVA CABG                                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8574  No strk/CVA CABG                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8575  Postop ren insuf                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8576  No postop ren insuf                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8577  Reop req bld grft oth                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8578  No reop req bld grft oth                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8579  Antplt med disch                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8580  Antplt med contraind                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8581  no antplt med disch                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8582  Bblock disch                                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8583  Bblock contraind                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8584  No bblock disch                                   M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8585  Antilipid treat disch                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8586  Antlip disch contra                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8587  No antlipid treat disch                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8588  Sys BP <140                                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8589  Sys BP >= 140                                     M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8590  Dia BP < 90                                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8591  Dia BP >= 90                                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8592  No BP measure                                     M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8593  Lipid pn results                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8594  No lipid prof perf                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8595  Ldl < 100                                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8596  No LDL perf                                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8597  Ldl >= 100                                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8598  Asp therp used                                    M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8599  No asp therp used                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8600  tPA initi w/in 3 hrs                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8601  No elig tPA init w/in 3 hrs                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8602  No tPA init w/in 3 hrs                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8603  Spok lang comp score                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8604  No high score spok lang                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8605  No spok lang comp score                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8606  Attention score                                   M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8607  No high score attention                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8608  No attention score                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8609  Memory score                                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8610  No high score memory                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8611  No memory score                                   M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8612  Moto speech score                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8613  No high score moto speech                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8614  No moto speech score                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8615  Reading score                                     M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8616  No high score reading                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8617  No reading score                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8618  Spok lang exp score                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8619  No high score spok lang exp                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8620  No spok lang exp score                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8621  Writing score                                     M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8622  No high score writing                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8623  No writing score                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8624  Swallowing score                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8625  No high score swallowing                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8626  No swallowing score                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8627  Surg proc w/in 30 days                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8628  No surg proc w/in 30 days                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8629  Doc antibio order b/4 surg                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8630  Doc antibio given b/4 surg                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8631  Pt no elg 4 order antbi give                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8632  Doc no antibi order b/4 surg                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8633  Pharm ther osteo rx                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8634  Pt no elg phar ther osteo                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8635  No pharm ther osteo rx                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8636  Flu immun admin/prev rec                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8637  Pt no elg receiv flu immun                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8638  Flu immun no admin/prev rec                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8639  Flu immun admin or prev rec                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8640  Pt no elg rec flu immun                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8641  Flu immun not admin/pre rec                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8642  Hrdshp rural w/o internet                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8643  Hrdshp w/o suff pharm w/eRx                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8644  EP no prescribe priv                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8645  Asthma measures grp                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8646  Asthma MG qual act perform                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8647  Fun stat score knee >= 0                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8648  Fun stat score knee < 0                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8649  Fun stat score knee pt noelg                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8650  Fun stat score knee not done                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8651  Fun stat score hip >= 0                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8652  Fun stat score hip < 0                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8653  Fun stat score hip pt no elg                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8654  Fun stat score hip not done                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8655  Fun stat score LE >= 0                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8656  Fun stat score LE < 0                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8657  Fun stat score LE pt no elg                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8658  Fun stat score LE not done                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8659  Fun stat score LS >= 0                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8660  Fun stat score LS < 0                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8661  Fun stat score LS pt no elg                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8662  Fun stat score LS not done                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8663  Fun stat score shdl >=0                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8664  Fun stat score shdl < 0                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8665  Fun stat score shdl pt no el                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8666  Fun stat score shdl not done                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8667  Fun stat score UE >=0                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8668  Fun stat score UE < 0                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8669  Fun stat score UE pt no elg                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8670  Fun stat score UE not done                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8671  Fun stat score neck/TS >=0                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8672  Fun stat score neck/TS < 0                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8673  Fun stat scor nek/TS pt no e                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8674  Fun stat scor nek/TS not don                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8675  BP Syst >= 140 mmHg                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8676  BP Diast >= 90 mmHg                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8677  BP Syst < 130 mmHg                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8678  BP Syst >=130 - 139 mmHg                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8679  BP Diast < 80 mmHg                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8680  BP Diast 80-89 mmHg                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8681  Pt hosp w/HF                                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8682  LVG test perf                                     M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8683  Pt not elig for LVF test                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8684  Pt not hosp w/HF                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8685  LVF test not perf                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8686  Toba smkr curr or 2 hand exp                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8687  No tob smkr cur no 2 hnd exp                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8688  Smkls tob cur; no 2 hnd exp                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8689  Toba use not assess                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8690  Curr toba smkr or 2 hand exp                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8691  No cur tob smkr no 2 hnd exp                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8692  Curr smkls tob; no 2 hnd exp                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G8693  Tobacco no assess                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9001  MCCD, initial rate                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9002  MCCD,maintenance rate                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9003  MCCD, risk adj hi, initial                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9004  MCCD, risk adj lo, initial                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9005  MCCD, risk adj, maintenance                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9006  MCCD, Home monitoring                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9007  MCCD, sch team conf                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9008  Mccd,phys coor-care ovrsght                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9009  MCCD, risk adj, level 3                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9010  MCCD, risk adj, level 4                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9011  MCCD, risk adj, level 5                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9012  Other Specified Case Mgmt                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9013  ESRD demo bundle level I                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9014  ESRD demo bundle-level II                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9016  Demo-smoking cessation coun                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9017  Amantadine HCL 100mg oral                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9018  Zanamivir,inhalation pwd 10m                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9019  Oseltamivir phosphate 75mg                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9020  Rimantadine HCL 100mg oral                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9033  Amantadine HCL oral brand                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9034  Zanamivir, inh pwdr, brand                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9035  Oseltamivir phosp, brand                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9036  Rimantadine HCL, brand                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9041  Low vision rehab occupationa                      A   0.69   0.28     0.28     0.28     0.28     0.04   1.01   1.01   1.01   1.01  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G9042  Low vision rehab orient/mobi                      A   0.25   0.25     0.25     0.25     0.25     0.01   0.51   0.51   0.51   0.51  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G9043  Low vision lowvision therapi                      A   0.25   0.25     0.25     0.25     0.25     0.01   0.51   0.51   0.51   0.51  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G9044  Low vision rehabilate teache                      A   0.24   0.19     0.19     0.19     0.19     0.01   0.44   0.44   0.44   0.44  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
G9050  Oncology work-up evaluation                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9051  Oncology tx decision-mgmt                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9052  Onc surveillance for disease                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9053  Onc expectant management pt                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9054  Onc supervision palliative                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9055  Onc visit unspecified NOS                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9056  Onc prac mgmt adheres guide                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9057  Onc pract mgmt differs trial                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9058  Onc prac mgmt disagree w/gui                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9059  Onc prac mgmt pt opt alterna                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9060  Onc prac mgmt dif pt comorb                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9061  Onc prac cond noadd by guide                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9062  Onc prac guide differs nos                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9063  Onc dx nsclc stgI no progres                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9064  Onc dx nsclc stg2 no progres                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9065  Onc dx nsclc stg3A no progre                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9066  Onc dx nsclc stg3B-4 metasta                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9067  Onc dx nsclc dx unknown nos                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9068  Onc dx sclc/nsclc limited                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9069  Onc dx sclc/nsclc ext at dx                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9070  Onc dx sclc/nsclc ext unknwn                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9071  Onc dx brst stg1-2B HR,nopro                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9072  Onc dx brst stg1-2 noprogres                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9073  Onc dx brst stg3-HR, no pro                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9074  Onc dx brst stg3-noprogress                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9075  Onc dx brst metastic/ recur                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9077  Onc dx prostate T1no progres                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9078  Onc dx prostate T2no progres                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9079  Onc dx prostate T3b-T4noprog                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9080  Onc dx prostate w/rise PSA                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9083  Onc dx prostate unknwn nos                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9084  Onc dx colon t1-3,n1-2,no pr                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9085  Onc dx colon T4, N0 w/o prog                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9086  Onc dx colon T1-4 no dx prog                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9087  Onc dx colon metas evid dx                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9088  Onc dx colon metas noevid dx                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9089  Onc dx colon extent unknown                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9090  Onc dx rectal T1-2 no progr                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9091  Onc dx rectal T3 N0 no prog                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9092  Onc dx rectal T1-3,N1-2noprg                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9093  Onc dx rectal T4,N,M0 no prg                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9094  Onc dx rectal M1 w/mets prog                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9095  Onc dx rectal extent unknwn                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9096  Onc dx esophag T1-T3 noprog                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9097  Onc dx esophageal T4 no prog                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9098  Onc dx esophageal mets recur                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9099  Onc dx esophageal unknown                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9100  Onc dx gastric no recurrence                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9101  Onc dx gastric p R1-R2noprog                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9102  Onc dx gastric unresectable                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9103  Onc dx gastric recurrent                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9104  Onc dx gastric unknown NOS                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9105  Onc dx pancreatc p R0 res no                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9106  Onc dx pancreatc p R1/R2 no                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9107  Onc dx pancreatic unresectab                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9108  Onc dx pancreatic unknwn NOS                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9109  Onc dx head/neck T1-T2no prg                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9110  Onc dx head/neck T3-4 noprog                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9111  Onc dx head/neck M1 mets rec                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9112  Onc dx head/neck ext unknown                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9113  Onc dx ovarian stg1A-B no pr                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9114  Onc dx ovarian stg1A-B or 2                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9115  Onc dx ovarian stg3/4 noprog                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9116  Onc dx ovarian recurrence                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9117  Onc dx ovarian unknown NOS                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9123  Onc dx CML chronic phase                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9124  Onc dx CML acceler phase                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9125  Onc dx CML blast phase                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9126  Onc dx CML remission                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9128  Onc dx multi myeloma stage I                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9129  Onc dx mult myeloma stg2 hig                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9130  Onc dx multi myeloma unknown                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9131  Onc dx brst unknown NOS                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9132  Onc dx prostate mets no cast                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9133  Onc dx prostate clinical met                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9134  Onc NHLstg 1-2 no relap no                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9135  Onc dx NHL stg 3-4 not relap                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9136  Onc dx NHL trans to lg Bcell                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9137  Onc dx NHL relapse/refractor                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9138  Onc dx NHL stg unknown                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9139  Onc dx CML dx status unknown                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9140  Frontier extended stay demo                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9141  Influenza A H1N1,admin w cou                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9142  Influenza A H1N1, vaccine                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9143  Warfarin respon genetic test                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
G9147  Outpt IV insulin tx any mea                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0001  Alcohol and/or drug assess                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0002  Alcohol and/or drug screenin                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0003  Alcohol and/or drug screenin                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0004  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0005  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0006  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0007  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0008  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0009  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0010  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0011  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0012  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0013  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0014  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0015  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0016  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0017  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0018  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0019  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0020  Alcohol and/or drug services                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0021  Alcohol and/or drug training                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0022  Alcohol and/or drug interven                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0023  Alcohol and/or drug outreach                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0024  Alcohol and/or drug preventi                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0025  Alcohol and/or drug preventi                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0026  Alcohol and/or drug preventi                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0027  Alcohol and/or drug preventi                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0028  Alcohol and/or drug preventi                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0029  Alcohol and/or drug preventi                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0030  Alcohol and/or drug hotline                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0031  MH health assess by non-md                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0032  MH svc plan dev by non-md                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0033  Oral med adm direct observe                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0034  Med trng & support per 15min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0035  MH partial hosp tx under 24h                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0036  Comm psy face-face per 15min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0037  Comm psy sup tx pgm per diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0038  Self-help/peer svc per 15min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0039  Asser com tx face-face/15min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0040  Assert comm tx pgm per diem                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0041  Fos c chld non-ther per diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0042  Fos c chld non-ther per mon                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0043  Supported housing, per diem                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0044  Supported housing, per month                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0045  Respite not-in-home per diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0046  Mental health service, nos                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0047  Alcohol/drug abuse svc nos                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0048  Spec coll non-blood:a/d test                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0049  Alcohol/drug screening                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H0050  Alcohol/drug service 15 min                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H1000  Prenatal care atrisk assessm                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H1001  Antepartum management                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H1002  Carecoordination prenatal                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H1003  Prenatal at risk education                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H1004  Follow up home visit/prental                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H1005  Prenatalcare enhanced srv pk                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H1010  Nonmed family planning ed                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H1011  Family assessment                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2000  Comp multidisipln evaluation                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2001  Rehabilitation program 1/2 d                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2010  Comprehensive med svc 15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2011  Crisis interven svc, 15 min                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2012  Behav hlth day treat, per hr                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2013  Psych hlth fac svc, per diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2014  Skills train and dev, 15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2015  Comp comm supp svc, 15 min                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2016  Comp comm supp svc, per diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2017  Psysoc rehab svc, per 15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2018  Psysoc rehab svc, per diem                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2019  Ther behav svc, per 15 min                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2020  Ther behav svc, per diem                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2021  Com wrap-around sv, 15 min                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2022  Com wrap-around sv, per diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2023  Supported employ, per 15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2024  Supported employ, per diem                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2025  Supp maint employ, 15 min                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2026  Supp maint employ, per diem                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2027  Psychoed svc, per 15 min                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2028  Sex offend tx svc, 15 min                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2029  Sex offend tx svc, per diem                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2030  MH clubhouse svc, per 15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2031  MH clubhouse svc, per diem                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2032  Activity therapy, per 15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2033  Multisys ther/juvenile 15min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2034  A/D halfway house, per diem                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2035  A/D tx program, per hour                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2036  A/D tx program, per diem                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
H2037  Dev delay prev dp ch, 15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0120  Tetracyclin injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0129  Abatacept injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0130  Abciximab injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0132  Acetylcysteine injection                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0133  Acyclovir injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0135  Adalimumab injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0150  Injection adenosine 6 MG                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0152  Adenosine injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0171  Adrenalin epinephrine inject                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0180  Agalsidase beta injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0190  Inj biperiden lactate/5 mg                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0200  Alatrofloxacin mesylate                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0205  Alglucerase injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0207  Amifostine                                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0210  Methyldopate hcl injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0215  Alefacept                                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0220  Alglucosidase alfa injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0256  Alpha 1 proteinase inhibitor                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0270  Alprostadil for injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0275  Alprostadil urethral suppos                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0278  Amikacin sulfate injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0280  Aminophyllin 250 MG inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0282  Amiodarone HCl                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0285  Amphotericin B                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0287  Amphotericin b lipid complex                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0288  Ampho b cholesteryl sulfate                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0289  Amphotericin b liposome inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0290  Ampicillin 500 MG inj                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0295  Ampicillin sodium per 1.5 gm                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0300  Amobarbital 125 MG inj                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0330  Succinycholine chloride inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0348  Anidulafungin injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0350  Injection anistreplase 30 u                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0360  Hydralazine hcl injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0364  Apomorphine hydrochloride                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0365  Aprotonin, 10,000 kiu                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0380  Inj metaraminol bitartrate                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0390  Chloroquine injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0395  Arbutamine hcl injection                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0400  Aripiprazole injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0456  Azithromycin                                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0461  Atropine sulfate injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0470  Dimecaprol injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0475  Baclofen 10 MG injection                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0476  Baclofen intrathecal trial                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0480  Basiliximab                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0500  Dicyclomine injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0515  Inj benztropine mesylate                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0520  Bethanechol chloride inject                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0558  PenG benzathine/procaine inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0561  Penicillin g benzathine inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0583  Bivalirudin                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0585  Injection,onabotulinumtoxinA                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0586  AbobotulinumtoxinA                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0587  Inj, rimabotulinumtoxinB                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0592  Buprenorphine hydrochloride                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0594  Busulfan injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0595  Butorphanol tartrate 1 mg                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0597  C-1 esterase, berinert                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0598  C-1 esterase, cinryze                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0600  Edetate calcium disodium inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0610  Calcium gluconate injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0620  Calcium glycer & lact/10 ML                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0630  Calcitonin salmon injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0636  Inj calcitriol per 0.1 mcg                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0637  Caspofungin acetate                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0638  Canakinumab injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0640  Leucovorin calcium injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0641  Levoleucovorin injection                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0670  Inj mepivacaine HCL/10 ml                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0690  Cefazolin sodium injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0692  Cefepime HCl for injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0694  Cefoxitin sodium injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0696  Ceftriaxone sodium injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0697  Sterile cefuroxime injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0698  Cefotaxime sodium injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0702  Betamethasone acet&sod phosp                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0706  Caffeine citrate injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0710  Cephapirin sodium injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0713  Inj ceftazidime per 500 mg                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0715  Ceftizoxime sodium / 500 MG                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0718  Certolizumab pegol inj                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0720  Chloramphenicol sodium injec                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0725  Chorionic gonadotropin/1000u                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0735  Clonidine hydrochloride                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0740  Cidofovir injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0743  Cilastatin sodium injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0744  Ciprofloxacin iv                                  E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0745  Inj codeine phosphate /30 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0760  Colchicine injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0770  Colistimethate sodium inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0775  Collagenase, clost hist inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0780  Prochlorperazine injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0795  Corticorelin ovine triflutal                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0800  Corticotropin injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0833  Cosyntropin injection NOS                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0834  Cosyntropin cortrosyn inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0850  Cytomegalovirus imm IV /vial                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0878  Daptomycin injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0881  Darbepoetin alfa, non-esrd                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0882  Darbepoetin alfa, esrd use                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0885  Epoetin alfa, non-esrd                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0886  Epoetin alfa 1000 units ESRD                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0894  Decitabine injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0895  Deferoxamine mesylate inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0900  Testosterone enanthate inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J0945  Brompheniramine maleate inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1000  Depo-estradiol cypionate inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1020  Methylprednisolone 20 MG inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1030  Methylprednisolone 40 MG inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1040  Methylprednisolone 80 MG inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1051  Medroxyprogesterone inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1055  Medrxyprogester acetate inj                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1056  MA/EC contraceptiveinjection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1060  Testosterone cypionate 1 ML                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1070  Testosterone cypionat 100 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1080  Testosterone cypionat 200 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1094  Inj dexamethasone acetate                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1100  Dexamethasone sodium phos                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1110  Inj dihydroergotamine mesylt                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1120  Acetazolamid sodium injectio                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1160  Digoxin injection                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1162  Digoxin immune fab (ovine)                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1165  Phenytoin sodium injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1170  Hydromorphone injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1180  Dyphylline injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1190  Dexrazoxane HCl injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1200  Diphenhydramine hcl injectio                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1205  Chlorothiazide sodium inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1212  Dimethyl sulfoxide 50% 50 ML                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1230  Methadone injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1240  Dimenhydrinate injection                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1245  Dipyridamole injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1250  Inj dobutamine HCL/250 mg                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1260  Dolasetron mesylate                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1265  Dopamine injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1267  Doripenem injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1270  Injection, doxercalciferol                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1290  Ecallantide injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1300  Eculizumab injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1320  Amitriptyline injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1324  Enfuvirtide injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1325  Epoprostenol injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1327  Eptifibatide injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1330  Ergonovine maleate injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1335  Ertapenem injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1364  Erythro lactobionate /500 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1380  Estradiol valerate 10 MG inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1410  Inj estrogen conjugate 25 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1430  Ethanolamine oleate 100 mg                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1435  Injection estrone per 1 MG                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1436  Etidronate disodium inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1438  Etanercept injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1440  Filgrastim 300 mcg injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1441  Filgrastim 480 mcg injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1450  Fluconazole                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1451  Fomepizole, 15 mg                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1452  Intraocular Fomivirsen na                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1453  Fosaprepitant injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1455  Foscarnet sodium injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1457  Gallium nitrate injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1458  Galsulfase injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1459  Inj IVIG privigen 500 mg                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1460  Gamma globulin 1 CC inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1559  Hizentra injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1560  Gamma globulin > 10 CC inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1561  Gamunex injection                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1562  Vivaglobin, inj                                   E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1566  Immune globulin, powder                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1568  Octagam injection                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1569  Gammagard liquid injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1570  Ganciclovir sodium injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1571  Hepagam b im injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1572  Flebogamma injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1573  Hepagam b intravenous, inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1580  Garamycin gentamicin inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1590  Gatifloxacin injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1595  Injection glatiramer acetate                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1599  Ivig non-lyophilized, NOS                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1600  Gold sodium thiomaleate inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1610  Glucagon hydrochloride/1 MG                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1620  Gonadorelin hydroch/ 100 mcg                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1626  Granisetron hcl injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1630  Haloperidol injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1631  Haloperidol decanoate inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1640  Hemin, 1 mg                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1642  Inj heparin sodium per 10 u                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1644  Inj heparin sodium per 1000u                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1645  Dalteparin sodium                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1650  Inj enoxaparin sodium                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1652  Fondaparinux sodium                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1655  Tinzaparin sodium injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1670  Tetanus immune globulin inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1675  Histrelin acetate                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1680  Human fibrinogen conc inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1700  Hydrocortisone acetate inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1710  Hydrocortisone sodium ph inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1720  Hydrocortisone sodium succ i                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1730  Diazoxide injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1740  Ibandronate sodium injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1742  Ibutilide fumarate injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1743  Idursulfase injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1745  Infliximab injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1750  Inj iron dextran                                  E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1756  Iron sucrose injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1786  Imuglucerase injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1790  Droperidol injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1800  Propranolol injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1810  Droperidol/fentanyl inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1815  Insulin injection                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1817  Insulin for insulin pump use                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1826  Interferon Beta-1A inj                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1830  Interferon beta-1b / .25 MG                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1835  Itraconazole injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1840  Kanamycin sulfate 500 MG inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1850  Kanamycin sulfate 75 MG inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1885  Ketorolac tromethamine inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1890  Cephalothin sodium injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1930  Lanreotide injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1931  Laronidase injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1940  Furosemide injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1945  Lepirudin                                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1950  Leuprolide acetate /3.75 MG                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1953  Levetiracetam injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1955  Inj levocarnitine per 1 gm                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1956  Levofloxacin injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1960  Levorphanol tartrate inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1980  Hyoscyamine sulfate inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J1990  Chlordiazepoxide injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2001  Lidocaine injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2010  Lincomycin injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2020  Linezolid injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2060  Lorazepam injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2150  Mannitol injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2170  Mecasermin injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2175  Meperidine hydrochl /100 MG                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2180  Meperidine/promethazine inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2185  Meropenem                                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2210  Methylergonovin maleate inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2248  Micafungin sodium injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2250  Inj midazolam hydrochloride                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2260  Inj milrinone lactate / 5 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2270  Morphine sulfate injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2271  Morphine so4 injection 100mg                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2275  Morphine sulfate injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2278  Ziconotide injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2280  Inj, moxifloxacin 100 mg                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2300  Inj nalbuphine hydrochloride                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2310  Inj naloxone hydrochloride                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2315  Naltrexone, depot form                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2320  Nandrolone decanoate 50 MG                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2323  Natalizumab injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2325  Nesiritide injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2353  Octreotide injection, depot                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2354  Octreotide inj, non-depot                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2355  Oprelvekin injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2357  Omalizumab injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2358  Olanzapine long-acting inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2360  Orphenadrine injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2370  Phenylephrine hcl injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2400  Chloroprocaine hcl injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2405  Ondansetron hcl injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2410  Oxymorphone hcl injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2425  Palifermin injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2426  Paliperidone palmitate inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2430  Pamidronate disodium /30 MG                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2440  Papaverin hcl injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2460  Oxytetracycline injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2469  Palonosetron hcl                                  E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2501  Paricalcitol                                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2503  Pegaptanib sodium injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2504  Pegademase bovine, 25 iu                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2505  Injection, pegfilgrastim 6mg                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2510  Penicillin g procaine inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2513  Pentastarch 10% solution                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2515  Pentobarbital sodium inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2540  Penicillin g potassium inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2543  Piperacillin/tazobactam                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2545  Pentamidine non-comp unit                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2550  Promethazine hcl injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2560  Phenobarbital sodium inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2562  Plerixafor injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2590  Oxytocin injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2597  Inj desmopressin acetate                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2650  Prednisolone acetate inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2670  Totazoline hcl injection                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2675  Inj progesterone per 50 MG                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2680  Fluphenazine decanoate 25 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2690  Procainamide hcl injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2700  Oxacillin sodium injeciton                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2710  Neostigmine methylslfte inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2720  Inj protamine sulfate/10 MG                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2724  Protein c concentrate                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2725  Inj protirelin per 250 mcg                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2730  Pralidoxime chloride inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2760  Phentolaine mesylate inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2765  Metoclopramide hcl injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2770  Quinupristin/dalfopristin                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2778  Ranibizumab injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2780  Ranitidine hydrochloride inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2783  Rasburicase                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2785  Regadenoson injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2788  Rho d immune globulin 50 mcg                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2790  Rho d immune globulin inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2791  Rhophylac injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2792  Rho(D) immune globulin h, sd                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2793  Rilonacept injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2794  Risperidone, long acting                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2795  Ropivacaine HCl injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2796  Romiplostim injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2800  Methocarbamol injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2805  Sincalide injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2810  Inj theophylline per 40 MG                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2820  Sargramostim injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2850  Inj secretin synthetic human                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2910  Aurothioglucose injeciton                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2916  Na ferric gluconate complex                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2920  Methylprednisolone injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2930  Methylprednisolone injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2940  Somatrem injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2941  Somatropin injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2950  Promazine hcl injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2993  Reteplase injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2995  Inj streptokinase /250000 IU                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J2997  Alteplase recombinant                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3000  Streptomycin injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3010  Fentanyl citrate injeciton                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3030  Sumatriptan succinate / 6 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3070  Pentazocine injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3095  Televancin injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3101  Tenecteplase injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3105  Terbutaline sulfate inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3110  Teriparatide injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3120  Testosterone enanthate inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3130  Testosterone enanthate inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3140  Testosterone suspension inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3150  Testosteron propionate inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3230  Chlorpromazine hcl injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3240  Thyrotropin injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3243  Tigecycline injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3246  Tirofiban HCl                                     E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3250  Trimethobenzamide hcl inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3260  Tobramycin sulfate injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3262  Tocilizumab injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3265  Injection torsemide 10 mg/ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3280  Thiethylperazine maleate inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3285  Treprostinil injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3300  Triamcinolone A inj PRS-free                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3301  Triamcinolone acet inj NOS                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3302  Triamcinolone diacetate inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3303  Triamcinolone hexacetonl inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3305  Inj trimetrexate glucoronate                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3310  Perphenazine injeciton                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3315  Triptorelin pamoate                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3320  Spectinomycn di-hcl inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3350  Urea injection                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3355  Urofollitropin, 75 iu                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3357  Ustekinumab injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3360  Diazepam injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3364  Urokinase 5000 IU injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3365  Urokinase 250,000 IU inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3370  Vancomycin hcl injection                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3385  Velaglucerase alfa                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3396  Verteporfin injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3400  Triflupromazine hcl inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3410  Hydroxyzine hcl injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3411  Thiamine hcl 100 mg                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3415  Pyridoxine hcl 100 mg                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3420  Vitamin b12 injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3430  Vitamin k phytonadione inj                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3465  Injection, voriconazole                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3470  Hyaluronidase injection                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3471  Ovine, up to 999 USP units                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3472  Ovine, 1000 USP units                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3473  Hyaluronidase recombinant                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3475  Inj magnesium sulfate                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3480  Inj potassium chloride                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3485  Zidovudine                                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3486  Ziprasidone mesylate                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3487  Zoledronic acid                                   E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3488  Reclast injection                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3490  Drugs unclassified injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3520  Edetate disodium per 150 mg                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3530  Nasal vaccine inhalation                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3535  Metered dose inhaler drug                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3570  Laetrile amygdalin vit B17                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J3590  Unclassified biologics                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7030  Normal saline solution infus                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7040  Normal saline solution infus                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7042  5% dextrose/normal saline                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7050  Normal saline solution infus                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7060  5% dextrose/water                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7070  D5w infusion                                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7100  Dextran 40 infusion                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7110  Dextran 75 infusion                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7120  Ringers lactate infusion                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7130  Hypertonic saline solution                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7184  Wilate injection                                  E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7185  Xyntha inj                                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7186  Antihemophilic viii/vwf comp                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7187  Humate-P, inj                                     E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7189  Factor viia                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7190  Factor viii                                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7191  Factor VIII (porcine)                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7192  Factor viii recombinant NOS                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7193  Factor IX non-recombinant                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7194  Factor ix complex                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7195  Factor IX recombinant                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7196  Antithrombin recombinant                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7197  Antithrombin iii injection                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7198  Anti-inhibitor                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7199  Hemophilia clot factor noc                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7300  Intraut copper contraceptive                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7302  Levonorgestrel iu contracept                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7303  Contraceptive vaginal ring                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7304  Contraceptive hormone patch                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7306  Levonorgestrel implant sys                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7307  Etonogestrel implant system                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7308  Aminolevulinic acid hcl top                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7309  Methyl aminolevulinate, top                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7310  Ganciclovir long act implant                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7311  Fluocinolone acetonide implt                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7312  Dexamethasone intra implant                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7321  Hyalgan/supartz inj per dose                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7323  Euflexxa inj per dose                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7324  Orthovisc inj per dose                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7325  Synvisc or Synvisc-One                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7330  Cultured chondrocytes implnt                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7335  Capsaicin 8% patch                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7500  Azathioprine oral 50mg                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7501  Azathioprine parenteral                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7502  Cyclosporine oral 100 mg                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7504  Lymphocyte immune globulin                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7505  Monoclonal antibodies                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7506  Prednisone oral                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7507  Tacrolimus oral per 1 MG                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7509  Methylprednisolone oral                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7510  Prednisolone oral per 5 mg                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7511  Antithymocyte globuln rabbit                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7513  Daclizumab, parenteral                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7515  Cyclosporine oral 25 mg                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7516  Cyclosporin parenteral 250mg                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7517  Mycophenolate mofetil oral                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7518  Mycophenolic acid                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7520  Sirolimus, oral                                   E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7525  Tacrolimus injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7599  Immunosuppressive drug noc                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7604  Acetylcysteine comp unit                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7605  Arformoterol non-comp unit                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7606  Formoterol fumarate, inh                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7607  Levalbuterol comp con                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7608  Acetylcysteine non-comp unit                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7609  Albuterol comp unit                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7610  Albuterol comp con                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7611  Albuterol non-comp con                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7612  Levalbuterol non-comp con                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7613  Albuterol non-comp unit                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7614  Levalbuterol non-comp unit                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7615  Levalbuterol comp unit                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7620  Albuterol ipratrop non-comp                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7622  Beclomethasone comp unit                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7624  Betamethasone comp unit                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7626  Budesonide non-comp unit                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7627  Budesonide comp unit                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7628  Bitolterol mesylate comp con                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7629  Bitolterol mesylate comp unt                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7631  Cromolyn sodium noncomp unit                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7632  Cromolyn sodium comp unit                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7633  Budesonide non-comp con                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7634  Budesonide comp con                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7635  Atropine comp con                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7636  Atropine comp unit                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7637  Dexamethasone comp con                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7638  Dexamethasone comp unit                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7639  Dornase alfa non-comp unit                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7640  Formoterol comp unit                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7641  Flunisolide comp unit                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7642  Glycopyrrolate comp con                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7643  Glycopyrrolate comp unit                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7644  Ipratropium bromide non-comp                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7645  Ipratropium bromide comp                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7647  Isoetharine comp con                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7648  Isoetharine non-comp con                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7649  Isoetharine non-comp unit                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7650  Isoetharine comp unit                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7657  Isoproterenol comp con                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7658  Isoproterenol non-comp con                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7659  Isoproterenol non-comp unit                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7660  Isoproterenol comp unit                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7667  Metaproterenol comp con                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7668  Metaproterenol non-comp con                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7669  Metaproterenol non-comp unit                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7670  Metaproterenol comp unit                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7674  Methacholine chloride, neb                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7676  Pentamidine comp unit dose                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7680  Terbutaline sulf comp con                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7681  Terbutaline sulf comp unit                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7682  Tobramycin non-comp unit                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7683  Triamcinolone comp con                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7684  Triamcinolone comp unit                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7685  Tobramycin comp unit                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7686  Treprostinil, non-comp unit                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7699  Inhalation solution for DME                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J7799  Non-inhalation drug for DME                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8498  Antiemetic rectal/supp NOS                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8499  Oral prescrip drug non chemo                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8501  Oral aprepitant                                   E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8510  Oral busulfan                                     E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8515  Cabergoline, oral 0.25mg                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8520  Capecitabine, oral, 150 mg                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8521  Capecitabine, oral, 500 mg                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8530  Cyclophosphamide oral 25 MG                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8540  Oral dexamethasone                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8560  Etoposide oral 50 MG                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8562  Oral fludarabine phosphate                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8565  Gefitinib oral                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8597  Antiemetic drug oral NOS                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8600  Melphalan oral 2 MG                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8610  Methotrexate oral 2.5 MG                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8650  Nabilone oral                                     E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8700  Temozolomide                                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8705  Topotecan oral                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J8999  Oral prescription drug chemo                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9000  Doxorubicin hcl injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9001  Doxorubicin hcl liposome inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9010  Alemtuzumab injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9015  Aldesleukin injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9017  Arsenic trioxide injection                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9020  Asparaginase injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9025  Azacitidine injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9027  Clofarabine injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9031  Bcg live intravesical vac                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9033  Bendamustine injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9035  Bevacizumab injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9040  Bleomycin sulfate injection                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9041  Bortezomib injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9045  Carboplatin injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9050  Carmustine injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9055  Cetuximab injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9060  Cisplatin 10 MG injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9065  Inj cladribine per 1 MG                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9070  Cyclophosphamide 100 MG inj                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9098  Cytarabine liposome inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9100  Cytarabine hcl 100 MG inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9120  Dactinomycin injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9130  Dacarbazine 100 mg inj                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9150  Daunorubicin injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9151  Daunorubicin citrate inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9155  Degarelix injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9160  Denileukin diftitox inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9165  Diethylstilbestrol injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9171  Docetaxel injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9175  Elliotts b solution per ml                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9178  Inj, epirubicin hcl, 2 mg                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9181  Etoposide injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9185  Fludarabine phosphate inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9190  Fluorouracil injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9200  Floxuridine injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9201  Gemcitabine hcl injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9202  Goserelin acetate implant                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9206  Irinotecan injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9207  Ixabepilone injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9208  Ifosfomide injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9209  Mesna injection                                   E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9211  Idarubicin hcl injection                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9212  Interferon alfacon-1 inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9213  Interferon alfa-2a inj                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9214  Interferon alfa-2b inj                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9215  Interferon alfa-n3 inj                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9216  Interferon gamma 1-b inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9217  Leuprolide acetate suspnsion                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9218  Leuprolide acetate injeciton                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9219  Leuprolide acetate implant                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9225  Vantas implant                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9226  Supprelin LA implant                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9230  Mechlorethamine hcl inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9245  Inj melphalan hydrochl 50 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9250  Methotrexate sodium inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9260  Methotrexate sodium inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9261  Nelarabine injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9263  Oxaliplatin                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9264  Paclitaxel protein bound                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9265  Paclitaxel injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9266  Pegaspargase injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9268  Pentostatin injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9270  Plicamycin (mithramycin) inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9280  Mitomycin 5 MG inj                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9293  Mitoxantrone hydrochl / 5 MG                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9300  Gemtuzumab ozogamicin inj                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9302  Ofatumumab injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9303  Panitumumab injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9305  Pemetrexed injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9307  Pralatrexate injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9310  Rituximab injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9315  Romidepsin injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9320  Streptozocin injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9328  Temozolomide injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9330  Temsirolimus injection                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9340  Thiotepa injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9351  Topotecan injection                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9355  Trastuzumab injection                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9357  Valrubicin injection                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9360  Vinblastine sulfate inj                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9370  Vincristine sulfate 1 MG inj                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9390  Vinorelbine tartrate inj                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9395  Injection, Fulvestrant                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9600  Porfimer sodium injection                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
J9999  Chemotherapy drug                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
M0064  Visit for drug monitoring                         A   0.37   0.99     1.08     0.09     0.08     0.01   1.37   1.46   0.47   0.46  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
M0075  Cellular therapy                                  N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
M0076  Prolotherapy                                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
M0100  Intragastric hypothermia                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
M0300  IV chelationtherapy                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
M0301  Fabric wrapping of aneurysm                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P2028  Cephalin floculation test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P2029  Congo red blood test                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P2031  Hair analysis                                     N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P2033  Blood thymol turbidity                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P2038  Blood mucoprotein                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P3000  Screen pap by tech w md supv                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P3001  Screening pap smear by phys                       A   0.42   0.40     0.42     0.40     0.42     0.03   0.85   0.87   0.85   0.87  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
P7001  Culture bacterial urine                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9010  Whole blood for transfusion                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9011  Blood split unit                                  E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9012  Cryoprecipitate each unit                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9016  RBC leukocytes reduced                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9017  Plasma 1 donor frz w/in 8 hr                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9019  Platelets, each unit                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9020  Plaelet rich plasma unit                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9021  Red blood cells unit                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9022  Washed red blood cells unit                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9023  Frozen plasma, pooled, sd                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9031  Platelets leukocytes reduced                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9032  Platelets, irradiated                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9033  Platelets leukoreduced irrad                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9034  Platelets, pheresis                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9035  Platelet pheres leukoreduced                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9036  Platelet pheresis irradiated                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9037  Plate pheres leukoredu irrad                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9038  RBC irradiated                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9039  RBC deglycerolized                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9040  RBC leukoreduced irradiated                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9041  Albumin (human),5%, 50ml                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9043  Plasma protein fract,5%,50ml                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9044  Cryoprecipitatereducedplasma                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9045  Albumin (human), 5%, 250 ml                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9046  Albumin (human), 25%, 20 ml                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9047  Albumin (human), 25%, 50ml                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9048  Plasmaprotein fract,5%,250ml                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9050  Granulocytes, pheresis unit                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9051  Blood, l/r, cmv-neg                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9052  Platelets, hla-m, l/r, unit                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9053  Plt, pher, l/r cmv-neg, irr                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9054  Blood, l/r, froz/degly/wash                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9055  Plt, aph/pher, l/r, cmv-neg                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9056  Blood, l/r, irradiated                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9057  RBC, frz/deg/wsh, l/r, irrad                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9058  RBC, l/r, cmv-neg, irrad                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9059  Plasma, frz between 8-24hour                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9060  Fr frz plasma donor retested                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9603  One-way allow prorated miles                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9604  One-way allow prorated trip                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9612  Catheterize for urine spec                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
P9615  Urine specimen collect mult                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0035  Cardiokymography                                  A   0.17   0.36     0.31     0.36NA   0.31 NA  0.02   0.55   0.50   0.55   0.50  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
Q0035TCCardiokymography                                  A   0.00   0.30     0.25     0.30NA   0.25 NA  0.01   0.31   0.26   0.31   0.26  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
Q003526Cardiokymography                                  A   0.17   0.06     0.06     0.06     0.06     0.01   0.24   0.24   0.24   0.24  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
Q0091  Obtaining screen pap smear                        A   0.37   0.88     0.88     0.15     0.17     0.03   1.28   1.28   0.55   0.57  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
Q0092  Set up port xray equipment                        A   0.00   0.59     0.65     0.59     0.65     0.01   0.60   0.66   0.60   0.66  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
Q0111  Wet mounts/ w preparations                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0112  Potassium hydroxide preps                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0113  Pinworm examinations                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0114  Fern test                                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0115  Post-coital mucous exam                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0138  Ferumoxytol, non-esrd                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0139  Ferumoxytol, esrd use                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0144  Azithromycin dihydrate, oral                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0163  Diphenhydramine HCl 50mg                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0164  Prochlorperazine maleate 5mg                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0165  Prochlorperazine maleate10mg                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0166  Granisetron hcl 1 mg oral                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0167  Dronabinol 2.5mg oral                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0168  Dronabinol 5mg oral                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0169  Promethazine HCl 12.5mg oral                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0170  Promethazine HCl 25 mg oral                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0171  Chlorpromazine HCl 10mg oral                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0172  Chlorpromazine HCl 25mg oral                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0173  Trimethobenzamide HCl 250mg                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0174  Thiethylperazine maleate10mg                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0175  Perphenazine 4mg oral                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0176  Perphenazine 8mg oral                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0177  Hydroxyzine pamoate 25mg                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0178  Hydroxyzine pamoate 50mg                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0179  Ondansetron hcl 8 mg oral                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0180  Dolasetron mesylate oral                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0181  Unspecified oral anti-emetic                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0478  Power adapter, combo vad                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0479  Power module combo vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0480  Driver pneumatic vad, rep                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0481  Microprcsr cu elec vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0482  Microprcsr cu combo vad, rep                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0483  Monitor elec vad, rep                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0484  Monitor elec or comb vad rep                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0485  Monitor cable elec vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0486  Mon cable elec/pneum vad rep                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0487  Leads any type vad, rep only                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0488  Pwr pack base elec vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0489  Pwr pck base combo vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0490  Emr pwr source elec vad, rep                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0491  Emr pwr source combo vad rep                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0492  Emr pwr cbl elec vad, rep                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0493  Emr pwr cbl combo vad, rep                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0494  Emr hd pmp elec/combo, rep                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0495  Charger elec/combo vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0496  Battery elec/combo vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0497  Bat clps elec/comb vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0498  Holster elec/combo vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0499  Belt/vest elec/combo vad rep                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0500  Filters elec/combo vad, rep                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0501  Shwr cov elec/combo vad, rep                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0502  Mobility cart pneum vad, rep                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0503  Battery pneum vad replacemnt                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0504  Pwr adpt pneum vad, rep veh                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0505  Miscl supply/accessory vad                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0506  Lith-ion batt elec/pneum VAD                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0510  Dispens fee immunosupressive                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0511  Sup fee antiem,antica,immuno                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0512  Px sup fee anti-can sub pres                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0513  Disp fee inhal drugs/30 days                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0514  Disp fee inhal drugs/90 days                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q0515  Sermorelin acetate injection                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q1003  Ntiol category 3                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q1004  Ntiol category 4                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q1005  Ntiol category 5                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2004  Bladder calculi irrig sol                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2009  Fosphenytoin inj PE                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2017  Teniposide, 50 mg                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2026  Radiesse injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2027  Sculptra injection                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2035  Afluria vacc, 3 yrs & >, im                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2036  Flulaval vacc, 3 yrs & >, im                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2037  Fluvirin vacc, 3 yrs & >, im                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2038  Fluzone vacc, 3 yrs & >, im                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q2039  NOS flu vacc, 3 yrs & >, im                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q3001  Brachytherapy Radioelements                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
Q3014  Telehealth facility fee                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q3025  IM inj interferon beta 1-a                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q3026  Subc inj interferon beta-1a                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q3031  Collagen skin test                                B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4001  Cast sup body cast plaster                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4002  Cast sup body cast fiberglas                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4003  Cast sup shoulder cast plstr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4004  Cast sup shoulder cast fbrgl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4005  Cast sup long arm adult plst                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4006  Cast sup long arm adult fbrg                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4007  Cast sup long arm ped plster                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4008  Cast sup long arm ped fbrgls                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4009  Cast sup sht arm adult plstr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4010  Cast sup sht arm adult fbrgl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4011  Cast sup sht arm ped plaster                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4012  Cast sup sht arm ped fbrglas                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4013  Cast sup gauntlet plaster                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4014  Cast sup gauntlet fiberglass                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4015  Cast sup gauntlet ped plster                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4016  Cast sup gauntlet ped fbrgls                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4017  Cast sup lng arm splint plst                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4018  Cast sup lng arm splint fbrg                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4019  Cast sup lng arm splnt ped p                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4020  Cast sup lng arm splnt ped f                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4021  Cast sup sht arm splint plst                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4022  Cast sup sht arm splint fbrg                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4023  Cast sup sht arm splnt ped p                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4024  Cast sup sht arm splnt ped f                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4025  Cast sup hip spica plaster                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4026  Cast sup hip spica fiberglas                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4027  Cast sup hip spica ped plstr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4028  Cast sup hip spica ped fbrgl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4029  Cast sup long leg plaster                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4030  Cast sup long leg fiberglass                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4031  Cast sup lng leg ped plaster                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4032  Cast sup lng leg ped fbrgls                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4033  Cast sup lng leg cylinder pl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4034  Cast sup lng leg cylinder fb                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4035  Cast sup lngleg cylndr ped p                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4036  Cast sup lngleg cylndr ped f                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4037  Cast sup shrt leg plaster                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4038  Cast sup shrt leg fiberglass                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4039  Cast sup shrt leg ped plster                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4040  Cast sup shrt leg ped fbrgls                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4041  Cast sup lng leg splnt plstr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4042  Cast sup lng leg splnt fbrgl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4043  Cast sup lng leg splnt ped p                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4044  Cast sup lng leg splnt ped f                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4045  Cast sup sht leg splnt plstr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4046  Cast sup sht leg splnt fbrgl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4047  Cast sup sht leg splnt ped p                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4048  Cast sup sht leg splnt ped f                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4049  Finger splint, static                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4050  Cast supplies unlisted                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4051  Splint supplies misc                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4074  Iloprost non-comp unit dose                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4081  Epoetin alfa, 100 units ESRD                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4082  Drug/bio NOC part B drug CAP                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4100  Skin substitute, NOS                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4101  Apligraf                                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4102  Oasis wound matrix                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4103  Oasis burn matrix                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4104  Integra BMWD                                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4105  Integra DRT                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4106  Dermagraft                                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4107  Graftjacket                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4108  Integra matrix                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4110  Primatrix                                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4111  Gammagraft                                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4112  Cymetra injectable                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4113  Graftjacket xpress                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4114  Integra flowable wound matri                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4115  Alloskin                                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4116  Alloderm                                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4117  Hyalomatrix                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4118  Matristem micromatrix                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4119  Matristem wound matrix                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4120  Matristem burn matrix                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q4121  Theraskin                                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5001  Hospice in patient home                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5002  Hospice in assisted living                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5003  Hospice in LT/non-skilled NF                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5004  Hospice in SNF                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5005  Hospice, inpatient hospital                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5006  Hospice in hospice facility                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5007  Hospice in LTCH                                   E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5008  Hospice in inpatient psych                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5009  Hospice care, NOS                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q5010  Hospice home care in hospice                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9951  LOCM >= 400 mg/ml iodine,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9953  Inj Fe-based MR contrast,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9954  Oral MR contrast, 100 ml                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9955  Inj perflexane lip micros,ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9956  Inj octafluoropropane mic,ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9957  Inj perflutren lip micros,ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9958  HOCM <=149 mg/ml iodine, 1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9959  HOCM 150-199mg/ml iodine,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9960  HOCM 200-249mg/ml iodine,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9961  HOCM 250-299mg/ml iodine,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9962  HOCM 300-349mg/ml iodine,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9963  HOCM 350-399mg/ml iodine,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9964  HOCM>= 400mg/ml iodine, 1ml                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9965  LOCM 100-199mg/ml iodine,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9966  LOCM 200-299mg/ml iodine,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9967  LOCM 300-399mg/ml iodine,1ml                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
Q9968  Visualization adjunct                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
R0070  Transport portable x-ray                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
R0075  Transport port x-ray multipl                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
R0076  Transport portable EKG                            B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0012  Butorphanol tartrate, nasal                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0014  Tacrine hydrochloride, 10 mg                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0017  Injection, aminocaproic acid                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0020  Injection, bupivicaine hydro                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0021  Injection, cefoperazone sod                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0023  Injection, cimetidine hydroc                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0028  Injection, famotidine, 20 mg                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0030  Injection, metronidazole                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0032  Injection, nafcillin sodium                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0034  Injection, ofloxacin, 400 mg                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0039  Injection, sulfamethoxazole                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0040  Injection, ticarcillin disod                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0073  Injection, aztreonam, 500 mg                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0074  Injection, cefotetan disodiu                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0077  Injection, clindamycin phosp                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0078  Injection, fosphenytoin sodi                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0080  Injection, pentamidine iseth                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0081  Injection, piperacillin sodi                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0088  Imatinib 100 mg                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0090  Sildenafil citrate, 25 mg                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0091  Granisetron 1mg                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0092  Hydromorphone 250 mg                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0093  Morphine 500 mg                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0104  Zidovudine, oral, 100 mg                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0106  Bupropion HCL SR 60 tablets                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0108  Mercaptopurine 50 mg                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0109  Methadone oral 5mg                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0117  Tretinoin topical 5 g                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0122  Inj menotropins 75 iu                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0126  Inj follitropin alfa 75 iu                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0128  Inj follitropin beta 75 iu                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0132  Inj ganirelix acetat 250 mcg                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0136  Clozapine, 25 mg                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0137  Didanosine, 25 mg                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0138  Finasteride, 5 mg                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0139  Minoxidil, 10 mg                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0140  Saquinavir, 200 mg                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0142  Colistimethate inh sol mg                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0145  Peg interferon alfa-2A/180                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0148  Peg interferon alfa-2b/10                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0155  Epoprostenol dilutant                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0156  Exemestane, 25 mg                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0157  Becaplermin gel 1%, 0.5 gm                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0160  Dextroamphetamine                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0164  Injection pantroprazole                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0166  Inj olanzapine 2.5mg                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0169  Calcitrol                                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0170  Anastrozole 1 mg                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0171  Bumetanide 0.5 mg                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0172  Chlorambucil 2 mg                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0174  Dolasetron 50 mg                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0175  Flutamide 125 mg                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0176  Hydroxyurea 500 mg                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0177  Levamisole 50 mg                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0178  Lomustine 10 mg                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0179  Megestrol 20 mg                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0181  Ondansetron 4 mg                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0182  Procarbazine 5 mg                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0183  Prochlorperazine 5 mg                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0187  Tamoxifen 10 mg                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0189  Testosterone pellet 75 mg                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0190  Mifepristone, oral, 200 mg                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0191  Misoprostol, oral, 200 mcg                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0194  Vitamin suppl 100 caps                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0195  Pneumo vaccine 5-9 yrs                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0197  Prenatal vitamins 30 day                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0199  Med abortion inc all ex drug                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0201  Partial hospitalization serv                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0207  Paramedicintercep nonhospals                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0208  Paramed intrcept nonvol                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0209  WC van mileage per mi                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0215  Nonemerg transp mileage                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0220  Medical conference by physic                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0221  Medical conference, 60 min                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0250  Comp geriatr assmt team                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0255  Hospice refer visit nonmd                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0257  End of life counseling                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0260  H&P for surgery                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0265  Genetic counsel 15 mins                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0270  Home std case rate 30 days                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0271  Home hospice case 30 days                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0272  Home episodic case 30 days                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0273  MD home visit outside cap                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0274  Nurse practr visit outs cap                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0280  Medical home, initial plan                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0281  Medical home, maintenance                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0302  Completed EPSDT                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0310  Hospitalist visit                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0315  Disease management program                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0316  Follow-up/reassessment                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0317  Disease mgmt per diem                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0320  RN telephone calls to DMP                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0340  Lifestyle mod 1st stage                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0341  Lifestyle mod 2 or 3 stage                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0342  Lifestyle mod 4th stage                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0390  Rout foot care per visit                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0395  Impression casting ft                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0400  Global eswl kidney                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0500  Dispos cont lens                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0504  Singl prscrp lens                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0506  Bifoc prscp lens                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0508  Trifoc prscrp lens                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0510  Non-prscrp lens                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0512  Daily cont lens                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0514  Color cont lens                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0515  Scleral lens liquid bandage                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0516  Safety frames                                     I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0518  Sunglass frames                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0580  Polycarb lens                                     I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0581  Nonstnd lens                                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0590  Misc integral lens serv                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0592  Comp cont lens eval                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0595  New lenses in pts old frame                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0601  Screening proctoscopy                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0610  Annual gynecological examina                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0612  Annual gynecological examina                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0613  Ann breast exam                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0618  Audiometry for hearing aid                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0620  Routine ophthalmological exa                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0621  Routine ophthalmological exa                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0622  Phys exam for college                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0625  Digital screening retina                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0630  Removal of sutures                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0800  Laser in situ keratomileusis                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0810  Photorefractive keratectomy                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S0812  Phototherap keratect                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S1001  Deluxe item                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S1002  Custom item                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S1015  IV tubing extension set                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S1016  Non-pvc intravenous administ                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S1030  Gluc monitor purchase                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S1031  Gluc monitor rental                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S1040  Cranial remolding orthosis                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2053  Transplantation of small int                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2054  Transplantation of multivisc                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2055  Harvesting of donor multivis                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2060  Lobar lung transplantation                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2061  Donor lobectomy (lung)                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2065  Simult panc kidn trans                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2066  Breast GAP flap reconst                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2067  Breast "stacked" DIEP/GAP                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2068  Breast DIEP or SIEA flap                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2070  Cysto laser tx ureteral calc                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2079  Lap esophagomyotomy                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2080  Laup                                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2083  Adjustment gastric band                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2095  Transcath emboliz microspher                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2102  Islet cell tissue transplant                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2103  Adrenal tissue transplant                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2107  Adoptive immunotherapy                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2112  Knee arthroscp harv                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2115  Periacetabular osteotomy                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2117  Arthroereisis, subtalar                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2118  Total hip resurfacing                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2120  Low density lipoprotein(LDL)                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2140  Cord blood harvesting                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2142  Cord blood-derived stem-cell                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2150  BMT harv/transpl 28d pkg                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2152  Solid organ transpl pkg                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2202  Echosclerotherapy                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2205  Minimally invasive direct co                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2206  Minimally invasive direct co                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2207  Minimally invasive direct co                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2208  Minimally invasive direct co                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2209  Minimally invasive direct co                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2225  Myringotomy laser-assist                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2230  Implant semi-imp hear                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2235  Implant auditory brain imp                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2260  Induced abortion 17-24 weeks                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2265  Induced abortion 25-28 wks                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2266  Induced abortion 29-31 wks                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2267  Induced abortion 32 or more                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2270  Insertion vaginal cylinder                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2300  Arthroscopy, shoulder, surgi                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2325  Hip core decompression                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2340  Chemodenervation of abductor                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2341  Chemodenerv adduct vocal                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2342  Nasal endoscop po debrid                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2344  Endosc balloon sinuplasty                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2348  Decompress disc RF lumbar                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2350  Diskectomy, anterior, with d                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2351  Diskectomy, anterior, with d                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2360  Vertebroplast cerv 1st                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2361  Vertebroplast cerv addl                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2400  Fetal surg congen hernia                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2401  Fetal surg urin trac obstr                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2402  Fetal surg cong cyst malf                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2403  Fetal surg pulmon sequest                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2404  Fetal surg myelomeningo                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2405  Fetal surg sacrococ teratoma                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2409  Fetal surg noc                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2411  Fetoscop laser ther TTTS                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S2900  Robotic surgical system                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3000  Bilat dil retinal exam                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3005  Eval self-assess depression                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3600  Stat lab                                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3601  Stat lab home/nf                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3620  Newborn metabolic screening                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3625  Maternal triple screen test                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3626  Maternal serum quad screen                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3628  PAMG-1 rapid assay for ROM                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3630  Eosinophil blood count                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3645  HIV-1 antibody testing of or                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3650  Saliva test, hormone level;                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3652  Saliva test, hormone level;                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3655  Antisperm antibodies test                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3708  Gastrointestinal fat absorpt                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3711  Circulating tumor cell test                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3713  KRAS mutation analysis                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3800  Genetic testing ALS                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3818  BRCA1 gene anal                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3819  BRCA2 gene anal                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3820  Comp BRCA1/BRCA2                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3822  Sing mutation brst/ovar                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3823  3 mutation brst/ovar                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3828  Comp MLH1 gene                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3829  Comp MSH2 gene                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3830  Gene test HNPCC comp                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3831  Gene test HNPCC single                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3833  Comp APC sequence                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3834  Sing mutation APC                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3835  Gene test cystic fibrosis                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3837  Gene test hemochromato                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3840  DNA analysis RET-oncogene                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3841  Gene test retinoblastoma                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3842  Gene test Hippel-Lindau                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3843  DNA analysis factor v                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3844  DNA analysis deafness                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3845  Gene test alpha-thalassemia                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3846  Gene test beta-thalassemia                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3847  Gene test Tay-Sachs                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3848  Gene test Gaucher                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3849  Gene test Niemann-Pick                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3850  Gene test sickle cell                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3851  Gene test canavan                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3852  DNA analysis APOE alzheimer                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3853  Gene test myo musclr dyst                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3854  Gene profile panel breast                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3855  Gene test presenilin-1 gene                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3860  Genet test cardiac ion-comp                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3861  Genetic test brugada                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3862  Genet test cardiac ion-spec                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3865  Comp genet test hyp cardiomy                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3866  Spec gene test hyp cardiomy                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3870  CGH test developmental delay                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3890  Fecal DNA analysis                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3900  Surface EMG                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3902  Ballistocardiogram                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3904  Masters two step                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S3905  Auto handheld diag nerv test                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4005  Interim labor facility globa                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4011  IVF package                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4013  Compl GIFT case rate                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4014  Compl ZIFT case rate                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4015  Complete IVF nos case rate                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4016  Frozen IVF case rate                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4017  IVF canc a stim case rate                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4018  F EMB trns canc case rate                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4020  IVF canc a aspir case rate                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4021  IVF canc p aspir case rate                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4022  Asst oocyte fert case rate                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4023  Incompl donor egg case rate                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4025  Donor serv IVF case rate                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4026  Procure donor sperm                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4027  Store prev froz embryos                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4028  Microsurg epi sperm asp                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4030  Sperm procure init visit                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4031  Sperm procure subs visit                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4035  Stimulated IUI case rate                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4037  Cryo embryo transf case rate                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4040  Monit store cryo embryo 30 d                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4042  Ovulation mgmt per cycle                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4981  Insert levonorgestrel ius                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4989  Contracept IUD                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4990  Nicotine patch legend                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4991  Nicotine patch nonlegend                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4993  Contraceptive pills for bc                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S4995  Smoking cessation gum                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5000  Prescription drug, generic                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5001  Prescription drug,brand name                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5010  5% dextrose and 0.45% saline                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5011  5% dextrose in lactated ring                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5012  5% dextrose with potassium                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5013  5%dextrose/0.45%saline1000ml                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5014  D5W/0.45NS w KCl and MGS04                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5035  HIT routine device maint                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5036  HIT device repair                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5100  Adult daycare services 15min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5101  Adult day care per half day                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5102  Adult day care per diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5105  Centerbased day care perdiem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5108  Homecare train pt 15 min                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5109  Homecare train pt session                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5110  Family homecare training 15m                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5111  Family homecare train/sessio                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5115  Nonfamily homecare train/15m                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5116  Nonfamily HC train/session                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5120  Chore services per 15 min                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5121  Chore services per diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5125  Attendant care service /15m                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5126  Attendant care service /diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5130  Homaker service nos per 15m                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5131  Homemaker service nos /diem                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5135  Adult companioncare per 15m                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5136  Adult companioncare per diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5140  Adult foster care per diem                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5141  Adult foster care per month                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5145  Child fostercare th per diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5146  Ther fostercare child /month                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5150  Unskilled respite care /15m                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5151  Unskilled respitecare /diem                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5160  Emer response sys instal&tst                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5161  Emer rspns sys serv permonth                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5162  Emer rspns system purchase                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5165  Home modifications per serv                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5170  Homedelivered prepared meal                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5175  Laundry serv,ext,prof,/order                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5180  HH respiratory thrpy in eval                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5181  HH respiratory thrpy nos/day                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5185  Med reminder serv per month                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5190  Wellness assessment by nonph                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5199  Personal care item nos each                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5497  HIT cath care noc                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5498  HIT simple cath care                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5501  HIT complex cath care                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5502  HIT interim cath care                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5517  HIT declotting kit                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5518  HIT cath repair kit                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5520  HIT picc insert kit                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5521  HIT midline cath insert kit                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5522  HIT picc insert no supp                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5523  HIP midline cath insert kit                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5550  Insulin rapid 5 u                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5551  Insulin most rapid 5 u                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5552  Insulin intermed 5 u                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5553  Insulin long acting 5 u                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5560  Insulin reuse pen 1.5 ml                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5561  Insulin reuse pen 3 ml                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5565  Insulin cartridge 150 u                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5566  Insulin cartridge 300 u                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5570  Insulin dispos pen 1.5 ml                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S5571  Insulin dispos pen 3 ml                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8030  Tantalum ring application                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8035  Magnetic source imaging                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8037  mrcp                                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8040  Topographic brain mapping                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8042  MRI low field                                     I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8049  Intraoperative radiation the                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8055  Us guidance fetal reduct                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8080  Scintimammography                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8085  Fluorine-18 fluorodeoxygluco                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8092  Electron beam computed tomog                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8096  Portable peak flow meter                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8097  Asthma kit                                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8100  Spacer without mask                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8101  Spacer with mask                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8110  Peak expiratory flow rate (p                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8120  O2 contents gas cubic ft                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8121  O2 contents liquid lb                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8185  Flutter device                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8186  Swivel adaptor                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8189  Trach supply noc                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8210  Mucus trap                                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8262  Mandib ortho repos device                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8265  Haberman feeder                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8270  Enuresis alarm                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8301  Infect control supplies NOS                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8415  Supplies for home delivery                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8420  Custom gradient sleev/glov                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8421  Ready gradient sleev/glov                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8422  Custom grad sleeve med                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8423  Custom grad sleeve heavy                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8424  Ready gradient sleeve                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8425  Custom grad glove med                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8426  Custom grad glove heavy                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8427  Ready gradient glove                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8428  Ready gradient gauntlet                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8429  Gradient pressure wrap                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8430  Padding for comprssn bdg                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8431  Compression bandage                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8450  Splint digit                                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8451  Splint wrist or ankle                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8452  Splint elbow                                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8460  Camisole post-mast                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8490  100 insulin syringes                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8940  Hippotherapy per session                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8948  Low-level laser trmt 15 min                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8950  Complex lymphedema therapy,                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8990  Pt or manip for maint                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S8999  Resuscitation bag                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9001  Home uterine monitor with or                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9007  Ultrafiltration monitor                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9015  Automated EEG monitoring                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9024  Paranasal sinus ultrasound                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9025  Omnicardiogram/cardiointegra                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9034  ESWL for gallstones                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9055  Procuren or other growth fac                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9056  Coma stimulation per diem                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9061  Medical supplies and equipme                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9075  Smoking cessation treatment                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9083  Urgent care center global                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9088  Services provided in urgent                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9090  Vertebral axial decompressio                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9097  Home visit wound care                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9098  Home phototherapy visit                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9109  CHF telemonitoring month                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9117  Back school visit                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9122  Home health aide or certifie                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9123  Nursing care in home RN                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9124  Nursing care, in the home; b                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9125  Respite care, in the home, p                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9126  Hospice care, in the home, p                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9127  Social work visit, in the ho                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9128  Speech therapy, in the home,                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9129  Occupational therapy, in the                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9131  PT in the home per diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9140  Diabetic Management Program,                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9141  Diabetic Management Program,                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9145  Insulin pump initiation                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9150  Evaluation by ocularist                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9152  Speech therapy, re-eval                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9208  Home mgmt preterm labor                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9209  Home mgmt PPROM                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9211  Home mgmt gest hypertension                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9212  Hm postpar hyper per diem                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9213  Hm preeclamp per diem                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9214  Hm gest dm per diem                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9325  HIT pain mgmt per diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9326  HIT cont pain per diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9327  HIT int pain per diem                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9328  HIT pain imp pump diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9329  HIT chemo per diem                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9330  HIT cont chem diem                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9331  HIT intermit chemo diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9335  HT hemodialysis diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9336  HIT cont anticoag diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9338  HIT immunotherapy diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9339  HIT periton dialysis diem                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9340  HIT enteral per diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9341  HIT enteral grav diem                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9342  HIT enteral pump diem                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9343  HIT enteral bolus nurs                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9345  HIT anti-hemophil diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9346  HIT alpha-1-proteinas diem                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9347  HIT longterm infusion diem                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9348  HIT sympathomim diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9349  HIT tocolysis diem                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9351  HIT cont antiemetic diem                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9353  HIT cont insulin diem                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9355  HIT chelation diem                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9357  HIT enzyme replace diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9359  HIT anti-tnf per diem                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9361  HIT diuretic infus diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9363  HIT anti-spasmotic diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9364  HIT tpn total diem                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9365  HIT tpn 1 liter diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9366  HIT tpn 2 liter diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9367  HIT tpn 3 liter diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9368  HIT tpn over 3l diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9370  HT inj antiemetic diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9372  HT inj anticoag diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9373  HIT hydra total diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9374  HIT hydra 1 liter diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9375  HIT hydra 2 liter diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9376  HIT hydra 3 liter diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9377  HIT hydra over 3l diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9379  HIT noc per diem                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9381  HIT high risk/escort                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9401  Anticoag clinic per session                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9430  Pharmacy comp/disp serv                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9433  Medical food oral 100% nutr                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9434  Mod solid food suppl                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9435  Medical foods for inborn err                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9436  Lamaze class                                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9437  Childbirth refresher class                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9438  Cesarean birth class                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9439  VBAC class                                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9441  Asthma education                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9442  Birthing class                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9443  Lactation class                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9444  Parenting class                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9445  PT education noc individ                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9446  PT education noc group                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9447  Infant safety class                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9449  Weight mgmt class                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9451  Exercise class                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9452  Nutrition class                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9453  Smoking cessation class                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9454  Stress mgmt class                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9455  Diabetic Management Program,                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9460  Diabetic Management Program,                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9465  Diabetic Management Program,                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9470  Nutritional counseling, diet                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9472  Cardiac rehabilitation progr                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9473  Pulmonary rehabilitation pro                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9474  Enterostomal therapy by a re                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9475  Ambulatory setting substance                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9476  Vestibular rehab per diem                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9480  Intensive outpatient psychia                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9482  Family stabilization 15 min                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9484  Crisis intervention per hour                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9485  Crisis intervention mental h                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9490  HIT corticosteroid/diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9494  HIT antibiotic total diem                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9497  HIT antibiotic q3h diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9500  HIT antibiotic q24h diem                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9501  HIT antibiotic q12h diem                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9502  HIT antibiotic q8h diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9503  HIT antibiotic q6h diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9504  HIT antibiotic q4h diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9529  Venipuncture home/snf                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9537  HT hem horm inj diem                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9538  HIT blood products diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9542  HT inj noc per diem                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9558  HT inj growth horm diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9559  HIT inj interferon diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9560  HT inj hormone diem                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9562  HT inj palivizumab diem                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9590  HT irrigation diem                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9810  HT pharm per hour                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9900  Christian Sci Pract visit                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9970  Health club membership yr                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9975  Transplant related per diem                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9976  Lodging per diem                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9977  Meals per diem                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9981  Med record copy admin                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9982  Med record copy per page                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9986  Not medically necessary svc                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9988  Serv part of phase I trial                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9989  Services outside US                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9990  Services provided as part of                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9991  Services provided as part of                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9992  Transportation costs to and                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9994  Lodging costs (e.g. hotel ch                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9996  Meals for clinical trial par                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
S9999  Sales tax                                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1000  Private duty/independent nsg                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1001  Nursing assessment/evaluatn                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1002  RN services up to 15 minutes                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1003  LPN/LVN services up to 15min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1004  Nsg aide service up to 15min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1005  Respite care service 15 min                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1006  Family/Couple Counseling                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1007  Treatment Plan Development                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1009  Child Sitting Services                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1010  Meals when Receive Services                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1012  Alcohol/Substance Abuse Skil                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1013  Sign Lang/Oral Interpreter                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1014  Telehealth transmit, per min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1015  Clinic service                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1016  Case management                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1017  Targeted case management                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1018  School-based IEP ser bundled                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1019  Personal care ser per 15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1020  Personal care ser per diem                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1021  HH Aide or cn aide per visit                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1022  Contracted services per day                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1023  Program intake assessment                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1024  Team evaluation & management                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1025  Ped compr care pkg, per diem                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1026  Ped compr care pkg, per hour                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1027  Family training & counseling                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1028  Home environment assessment                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1029  Dwelling lead investigation                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1030  RN home care per diem                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1031  LPN home care per diem                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1502  Medication admin visit                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1503  Med admin, not oral/inject                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1505  Elec med comp dev, noc                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T1999  NOC retail items andsupplies                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2001  N-et; patient attend/escort                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2002  N-et; per diem                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2003  N-et; encounter/trip                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2004  N-et; commerc carrier pass                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2005  N-et; stretcher van                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2007  Non-emer transport wait time                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2010  PASRR Level I                                     I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2011  PASRR Level II                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2012  Habil ed waiver, per diem                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2013  Habil ed waiver per hour                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2014  Habil prevoc waiver, per d                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2015  Habil prevoc waiver per hr                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2016  Habil res waiver per diem                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2017  Habil res waiver 15 min                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2018  Habil sup empl waiver/diem                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2019  Habil sup empl waiver 15min                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2020  Day habil waiver per diem                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2021  Day habil waiver per 15 min                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2022  Case management, per month                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2023  Targeted case mgmt per month                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2024  Serv asmnt/care plan waiver                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2025  Waiver service, nos                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2026  Special childcare waiver/d                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2027  Spec childcare waiver 15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2028  Special supply, nos waiver                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2029  Special med equip, noswaiver                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2030  Assist living waiver/month                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2031  Assist living waiver/diem                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2032  Res care, nos waiver/month                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2033  Res, nos waiver per diem                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2034  Crisis interven waiver/diem                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2035  Utility services waiver                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2036  Camp overnite waiver/session                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2037  Camp day waiver/session                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2038  Comm trans waiver/service                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2039  Vehicle mod waiver/service                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2040  Financial mgt waiver/15min                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2041  Support broker waiver/15 min                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2042  Hospice routine home care                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2043  Hospice continuous home care                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2044  Hospice respite care                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2045  Hospice general care                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2046  Hospice long term care, r&b                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2048  Bh ltc res r&b, per diem                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2049  N-ET; stretcher van, mileage                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T2101  Breast milk proc/store/dist                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4521  Adult size brief/diaper sm                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4522  Adult size brief/diaper med                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4523  Adult size brief/diaper lg                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4524  Adult size brief/diaper xl                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4525  Adult size pull-on sm                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4526  Adult size pull-on med                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4527  Adult size pull-on lg                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4528  Adult size pull-on xl                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4529  Ped size brief/diaper sm/med                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4530  Ped size brief/diaper lg                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4531  Ped size pull-on sm/med                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4532  Ped size pull-on lg                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4533  Youth size brief/diaper                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4534  Youth size pull-on                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4535  Disposable liner/shield/pad                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4536  Reusable pull-on any size                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4537  Reusable underpad bed size                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4538  Diaper serv reusable diaper                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4539  Reuse diaper/brief any size                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4540  Reusable underpad chair size                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4541  Large disposable underpad                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4542  Small disposable underpad                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T4543  Disp bariatric brief/diaper                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T5001  Position seat spec orth need                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
T5999  Supply, nos                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2020  Vision svcs frames purchases                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2025  Eyeglasses delux frames                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2100  Lens spher single plano 4.00                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2101  Single visn sphere 4.12-7.00                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2102  Singl visn sphere 7.12-20.00                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2103  Spherocylindr 4.00d/12-2.00d                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2104  Spherocylindr 4.00d/2.12-4d                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2105  Spherocylinder 4.00d/4.25-6d                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2106  Spherocylinder 4.00d/>6.00d                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2107  Spherocylinder 4.25d/12-2d                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2108  Spherocylinder 4.25d/2.12-4d                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2109  Spherocylinder 4.25d/4.25-6d                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2110  Spherocylinder 4.25d/over 6d                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2111  Spherocylindr 7.25d/.25-2.25                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2112  Spherocylindr 7.25d/2.25-4d                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2113  Spherocylindr 7.25d/4.25-6d                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2114  Spherocylinder over 12.00d                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2115  Lens lenticular bifocal                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2118  Lens aniseikonic single                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2121  Lenticular lens, single                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2199  Lens single vision not oth c                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2200  Lens spher bifoc plano 4.00d                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2201  Lens sphere bifocal 4.12-7.0                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2202  Lens sphere bifocal 7.12-20.                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2203  Lens sphcyl bifocal 4.00d/.1                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2204  Lens sphcy bifocal 4.00d/2.1                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2205  Lens sphcy bifocal 4.00d/4.2                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2206  Lens sphcy bifocal 4.00d/ove                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2207  Lens sphcy bifocal 4.25-7d/.                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2208  Lens sphcy bifocal 4.25-7/2.                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2209  Lens sphcy bifocal 4.25-7/4.                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2210  Lens sphcy bifocal 4.25-7/ov                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2211  Lens sphcy bifo 7.25-12/.25-                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2212  Lens sphcyl bifo 7.25-12/2.2                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2213  Lens sphcyl bifo 7.25-12/4.2                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2214  Lens sphcyl bifocal over 12.                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2215  Lens lenticular bifocal                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2218  Lens aniseikonic bifocal                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2219  Lens bifocal seg width over                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2220  Lens bifocal add over 3.25d                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2221  Lenticular lens, bifocal                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2299  Lens bifocal speciality                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2300  Lens sphere trifocal 4.00d                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2301  Lens sphere trifocal 4.12-7.                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2302  Lens sphere trifocal 7.12-20                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2303  Lens sphcy trifocal 4.0/.12-                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2304  Lens sphcy trifocal 4.0/2.25                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2305  Lens sphcy trifocal 4.0/4.25                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2306  Lens sphcyl trifocal 4.00/>6                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2307  Lens sphcy trifocal 4.25-7/.                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2308  Lens sphc trifocal 4.25-7/2.                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2309  Lens sphc trifocal 4.25-7/4.                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2310  Lens sphc trifocal 4.25-7/>6                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2311  Lens sphc trifo 7.25-12/.25-                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2312  Lens sphc trifo 7.25-12/2.25                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2313  Lens sphc trifo 7.25-12/4.25                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2314  Lens sphcyl trifocal over 12                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2315  Lens lenticular trifocal                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2318  Lens aniseikonic trifocal                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2319  Lens trifocal seg width > 28                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2320  Lens trifocal add over 3.25d                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2321  Lenticular lens, trifocal                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2399  Lens trifocal speciality                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2410  Lens variab asphericity sing                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2430  Lens variable asphericity bi                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2499  Variable asphericity lens                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2500  Contact lens pmma spherical                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2501  Cntct lens pmma-toric/prism                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2502  Contact lens pmma bifocal                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2503  Cntct lens pmma color vision                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2510  Cntct gas permeable sphericl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2511  Cntct toric prism ballast                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2512  Cntct lens gas permbl bifocl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2513  Contact lens extended wear                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2520  Contact lens hydrophilic                          P   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2521  Cntct lens hydrophilic toric                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2522  Cntct lens hydrophil bifocl                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2523  Cntct lens hydrophil extend                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2530  Contact lens gas impermeable                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2531  Contact lens gas permeable                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2599  Contact lens/es other type                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2600  Hand held low vision aids                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2610  Single lens spectacle mount                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2615  Telescop/othr compound lens                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2623  Plastic eye prosth custom                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2624  Polishing artifical eye                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2625  Enlargemnt of eye prosthesis                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2626  Reduction of eye prosthesis                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2627  Scleral cover shell                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2628  Fabrication & fitting                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2629  Prosthetic eye other type                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2630  Anter chamber intraocul lens                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2631  Iris support intraoclr lens                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2632  Post chmbr intraocular lens                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2700  Balance lens                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2702  Deluxe lens feature                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2710  Glass/plastic slab off prism                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2715  Prism lens/es                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2718  Fresnell prism press-on lens                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2730  Special base curve                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2744  Tint photochromatic lens/es                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2745  Tint, any color/solid/grad                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2750  Anti-reflective coating                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2755  UV lens/es                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2756  Eye glass case                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2760  Scratch resistant coating                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2761  Mirror coating                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2762  Polarization, any lens                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2770  Occluder lens/es                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2780  Oversize lens/es                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2781  Progressive lens per lens                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2782  Lens, 1.54-1.65 p/1.60-1.79g                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2783  Lens, >= 1.66 p/>=1.80 g                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2784  Lens polycarb or equal                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2785  Corneal tissue processing                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2786  Occupational multifocal lens                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2787  Astigmatism-correct function                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2788  Presbyopia-correct function                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2790  Amniotic membrane                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2797  Vis item/svc in other code                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V2799  Miscellaneous vision service                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5008  Hearing screening                                 N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5010  Assessment for hearing aid                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5011  Hearing aid fitting/checking                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5014  Hearing aid repair/modifying                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5020  Conformity evaluation                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5030  Body-worn hearing aid air                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5040  Body-worn hearing aid bone                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5050  Hearing aid monaural in ear                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5060  Behind ear hearing aid                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5070  Glasses air conduction                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5080  Glasses bone conduction                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5090  Hearing aid dispensing fee                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5095  Implant mid ear hearing pros                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5100  Body-worn bilat hearing aid                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5110  Hearing aid dispensing fee                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5120  Body-worn binaur hearing aid                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5130  In ear binaural hearing aid                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5140  Behind ear binaur hearing ai                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5150  Glasses binaural hearing aid                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5160  Dispensing fee binaural                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5170  Within ear cros hearing aid                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5180  Behind ear cros hearing aid                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5190  Glasses cros hearing aid                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5200  Cros hearing aid dispens fee                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5210  In ear bicros hearing aid                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5220  Behind ear bicros hearing ai                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5230  Glasses bicros hearing aid                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5240  Dispensing fee bicros                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5241  Dispensing fee, monaural                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5242  Hearing aid, monaural, cic                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5243  Hearing aid, monaural, itc                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5244  Hearing aid, prog, mon, cic                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5245  Hearing aid, prog, mon, itc                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5246  Hearing aid, prog, mon, ite                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5247  Hearing aid, prog, mon, bte                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5248  Hearing aid, binaural, cic                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5249  Hearing aid, binaural, itc                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5250  Hearing aid, prog, bin, cic                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5251  Hearing aid, prog, bin, itc                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5252  Hearing aid, prog, bin, ite                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5253  Hearing aid, prog, bin, bte                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5254  Hearing id, digit, mon, cic                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5255  Hearing aid, digit, mon, itc                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5256  Hearing aid, digit, mon, ite                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5257  Hearing aid, digit, mon, bte                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5258  Hearing aid, digit, bin, cic                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5259  Hearing aid, digit, bin, itc                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5260  Hearing aid, digit, bin, ite                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5261  Hearing aid, digit, bin, bte                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5262  Hearing aid, disp, monaural                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5263  Hearing aid, disp, binaural                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5264  Ear mold/insert                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5265  Ear mold/insert, disp                             N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5266  Battery for hearing device                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5267  Hearing aid supply/accessory                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5268  ALD Telephone Amplifier                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5269  Alerting device, any type                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5270  ALD, TV amplifier, any type                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5271  ALD, TV caption decoder                           N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5272  Tdd                                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5273  ALD for cochlear implant                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5274  ALD unspecified                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5275  Ear impression                                    N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5298  Hearing aid noc                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5299  Hearing service                                   R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
V5336  Repair communication device                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
V5362  Speech screening                                  N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
V5363  Language screening                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
V5364  Dysphagia screening                               N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
0001F  Heart failure composite                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0005F  Osteoarthritis composite                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00100  Anesth salivary gland                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00102  Anesth repair of cleft lip                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00103  Anesth blepharoplasty                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00104  Anesth electroshock                               J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0012F  Cap bacterial assess                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00120  Anesth ear surgery                                J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00124  Anesth ear exam                                   J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00126  Anesth tympanotomy                                J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0014F  Comp preop assess cat surg                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00140  Anesth procedures on eye                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00142  Anesth lens surgery                               J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00144  Anesth corneal transplant                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00145  Anesth vitreoretinal surg                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00147  Anesth iridectomy                                 J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00148  Anesth eye exam                                   J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0015F  Melan follow-up complete                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00160  Anesth nose/sinus surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00162  Anesth nose/sinus surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00164  Anesth biopsy of nose                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00170  Anesth procedure on mouth                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00172  Anesth cleft palate repair                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00174  Anesth pharyngeal surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00176  Anesth pharyngeal surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0019T  Extracorp shock wv tx ms nos                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00190  Anesth face/skull bone surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00192  Anesth facial bone surgery                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00210  Anesth cranial surg nos                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00211  Anesth cran surg hemotoma                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00212  Anesth skull drainage                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00214  Anesth skull drainage                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00215  Anesth skull repair/fract                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00216  Anesth head vessel surgery                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00218  Anesth special head surgery                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00220  Anesth intrcrn nerve                              J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00222  Anesth head nerve surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0030T  Antiprothrombin antibody                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00300  Anesth head/neck/ptrunk                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00320  Anesth neck organ 1 & over                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00322  Anesth biopsy of thyroid                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00326  Anesth larynx/trach < 1 yr                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00350  Anesth neck vessel surgery                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00352  Anesth neck vessel surgery                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00400  Anesth skin ext/per/atrunk                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00402  Anesth surgery of breast                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00404  Anesth surgery of breast                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00406  Anesth surgery of breast                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00410  Anesth correct heart rhythm                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0042T  Ct perfusion w/contrast cbf                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00450  Anesth surgery of shoulder                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00452  Anesth surgery of shoulder                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00454  Anesth collar bone biopsy                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00470  Anesth removal of rib                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00472  Anesth chest wall repair                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00474  Anesth surgery of rib(s)                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0048T  Implant ventricular device                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0050T  Removal circulation assist                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00500  Anesth esophageal surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0051T  Implant total heart system                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0052T  Replace component heart syst                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00520  Anesth chest procedure                            J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00522  Anesth chest lining biopsy                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00524  Anesth chest drainage                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00528  Anesth chest partition view                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00529  Anesth chest partition view                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0053T  Replace component heart syst                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00530  Anesth pacemaker insertion                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00532  Anesth vascular access                            J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00534  Anesth cardioverter/defib                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00537  Anesth cardiac electrophys                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00539  Anesth trach-bronch reconst                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0054T  Bone surgery using computer                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00540  Anesth chest surgery                              J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00541  Anesth one lung ventilation                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00542  Anesth release of lung                            J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00546  Anesth lung chest wall surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00548  Anesth trachea bronchi surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0055T  Bone surgery using computer                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00550  Anesth sternal debridement                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00560  Anesth heart surg w/o pump                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00561  Anesth heart surg < 1 yr                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00562  Anesth hrt surg w/pmp age 1+                      J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00563  Anesth heart surg w/arrest                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00566  Anesth cabg w/o pump                              J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00567  Anesth cabg w/pump                                J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0058T  Cryopreservation ovary tiss                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00580  Anesth heart/lung transplnt                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0059T  Cryopreservation oocyte                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00600  Anesth spine cord surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00604  Anesth sitting procedure                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00620  Anesth spine cord surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00622  Anesth removal of nerves                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00625  Anes spine tranthor w/o vent                      J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00626  Anes spine transthor w/vent                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00630  Anesth spine cord surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00632  Anesth removal of nerves                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00634  Anesth for chemonucleolysis                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00635  Anesth lumbar puncture                            J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00640  Anesth spine manipulation                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00670  Anesth spine cord surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00700  Anesth abdominal wall surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00702  Anesth for liver biopsy                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0071T  U/s leiomyomata ablate <200                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0072T  U/s leiomyomata ablate >200                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0073T  Delivery comp imrt                                A   0.00  15.38    13.38    15.38NA  13.38 NA  0.01  15.39  13.39  15.39  13.39  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00730  Anesth abdominal wall surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00740  Anesth upper gi visualize                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0075T  Perq stent/chest vert art                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0075TTCPerq stent/chest vert art                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0075T26Perq stent/chest vert art                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00750  Anesth repair of hernia                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00752  Anesth repair of hernia                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00754  Anesth repair of hernia                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00756  Anesth repair of hernia                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0076T  S&i stent/chest vert art                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0076TTCS&i stent/chest vert art                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0076T26S&i stent/chest vert art                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00770  Anesth blood vessel repair                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0078T  Endovasc aort repr w/device                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0079T  Endovasc visc extnsn repr                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00790  Anesth surg upper abdomen                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00792  Anesth hemorr/excise liver                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00794  Anesth pancreas removal                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00796  Anesth for liver transplant                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00797  Anesth surgery for obesity                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0080T  Endovasc aort repr rad s&i                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00800  Anesth abdominal wall surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00802  Anesth fat layer removal                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0081T  Endovasc visc extnsn s&i                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00810  Anesth low intestine scope                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00820  Anesth abdominal wall surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00830  Anesth repair of hernia                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00832  Anesth repair of hernia                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00834  Anesth hernia repair < 1 yr                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00836  Anesth hernia repair preemie                      J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00840  Anesth surg lower abdomen                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00842  Anesth amniocentesis                              J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00844  Anesth pelvis surgery                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00846  Anesth hysterectomy                               J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00848  Anesth pelvic organ surg                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0085T  Breath test heart reject                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00851  Anesth tubal ligation                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00860  Anesth surgery of abdomen                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00862  Anesth kidney/ureter surg                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00864  Anesth removal of bladder                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00865  Anesth removal of prostate                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00866  Anesth removal of adrenal                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00868  Anesth kidney transplant                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00870  Anesth bladder stone surg                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00872  Anesth kidney stone destruct                      J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00873  Anesth kidney stone destruct                      J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00880  Anesth abdomen vessel surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00882  Anesth major vein ligation                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00902  Anesth anorectal surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00904  Anesth perineal surgery                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00906  Anesth removal of vulva                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00908  Anesth removal of prostate                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00910  Anesth bladder surgery                            J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00912  Anesth bladder tumor surg                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00914  Anesth removal of prostate                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00916  Anesth bleeding control                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00918  Anesth stone removal                              J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0092T  Artific disc addl                                 C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00920  Anesth genitalia surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00921  Anesth vasectomy                                  J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00922  Anesth sperm duct surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00924  Anesth testis exploration                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00926  Anesth removal of testis                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00928  Anesth removal of testis                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00930  Anesth testis suspension                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00932  Anesth amputation of penis                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00934  Anesth penis nodes removal                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00936  Anesth penis nodes removal                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00938  Anesth insert penis device                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00940  Anesth vaginal procedures                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00942  Anesth surg on vag/urethral                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00944  Anesth vaginal hysterectomy                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00948  Anesth repair of cervix                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0095T  Artific diskectomy addl                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
00950  Anesth vaginal endoscopy                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
00952  Anesth hysteroscope/graph                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0098T  Rev artific disc addl                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0099T  Implant corneal ring                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0100T  Prosth retina receive&gen                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0101T  Extracorp shockwv tx hi enrg                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0102T  Extracorp shockwv tx anesth                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0103T  Holotranscobalamin                                C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0106T  Touch quant sensory test                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0107T  Vibrate quant sensory test                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0108T  Cool quant sensory test                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0109T  Heat quant sensory test                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0110T  Nos quant sensory test                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0111T  Rbc membranes fatty acids                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01112  Anesth bone aspirate/bx                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01120  Anesth pelvis surgery                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01130  Anesth body cast procedure                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01140  Anesth amputation at pelvis                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01150  Anesth pelvic tumor surgery                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01160  Anesth pelvis procedure                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01170  Anesth pelvis surgery                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01173  Anesth fx repair pelvis                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01180  Anesth pelvis nerve removal                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01190  Anesth pelvis nerve removal                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01200  Anesth hip joint procedure                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01202  Anesth arthroscopy of hip                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01210  Anesth hip joint surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01212  Anesth hip disarticulation                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01214  Anesth hip arthroplasty                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01215  Anesth revise hip repair                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01220  Anesth procedure on femur                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0123T  Scleral fistulization                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01230  Anesth surgery of femur                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01232  Anesth amputation of femur                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01234  Anesth radical femur surg                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0124T  Conjunctival drug placement                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01250  Anesth upper leg surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0126T  Chd risk imt study                                C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01260  Anesth upper leg veins surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01270  Anesth thigh arteries surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01272  Anesth femoral artery surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01274  Anesth femoral embolectomy                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01320  Anesth knee area surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01340  Anesth knee area procedure                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01360  Anesth knee area surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01380  Anesth knee joint procedure                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01382  Anesth dx knee arthroscopy                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01390  Anesth knee area procedure                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01392  Anesth knee area surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01400  Anesth knee joint surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01402  Anesth knee arthroplasty                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01404  Anesth amputation at knee                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0141T  Perq islet transplant                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0142T  Open islet transplant                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01420  Anesth knee joint casting                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0143T  Laparoscopic islet transplnt                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01430  Anesth knee veins surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01432  Anesth knee vessel surg                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01440  Anesth knee arteries surg                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01442  Anesth knee artery surg                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01444  Anesth knee artery repair                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01462  Anesth lower leg procedure                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01464  Anesth ankle/ft arthroscopy                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01470  Anesth lower leg surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01472  Anesth achilles tendon surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01474  Anesth lower leg surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01480  Anesth lower leg bone surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01482  Anesth radical leg surgery                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01484  Anesth lower leg revision                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01486  Anesth ankle replacement                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01490  Anesth lower leg casting                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01500  Anesth leg arteries surg                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01502  Anesth lwr leg embolectomy                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01520  Anesth lower leg vein surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01522  Anesth lower leg vein surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0155T  Lap impl gast curve electrd                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0156T  Lap remv gast curve electrd                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0157T  Open impl gast curve electrd                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0158T  Open remv gast curve electrd                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0159T  Cad breast mri                                    C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0159TTCCad breast mri                                    C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0159T26Cad breast mri                                    C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01610  Anesth surgery of shoulder                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01620  Anesth shoulder procedure                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01622  Anes dx shoulder arthroscopy                      J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0163T  Lumb artif diskectomy addl                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01630  Anesth surgery of shoulder                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01634  Anesth shoulder joint amput                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01636  Anesth forequarter amput                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01638  Anesth shoulder replacement                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0164T  Remove lumb artif disc addl                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0165T  Revise lumb artif disc addl                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01650  Anesth shoulder artery surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01652  Anesth shoulder vessel surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01654  Anesth shoulder vessel surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01656  Anesth arm-leg vessel surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0166T  Tcath vsd close w/o bypass                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0167T  Tcath vsd close w/bypass                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01670  Anesth shoulder vein surg                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0168T  Rhinophototx light app bilat                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01680  Anesth shoulder casting                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01682  Anesth airplane cast                              J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0169T  Place stereo cath brain                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0171T  Lumbar spine proces distract                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01710  Anesth elbow area surgery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01712  Anesth uppr arm tendon surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01714  Anesth uppr arm tendon surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01716  Anesth biceps tendon repair                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0172T  Lumbar spine process addl                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0173T  Iop monit io pressure                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01730  Anesth uppr arm procedure                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01732  Anesth dx elbow arthroscopy                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0174T  Cad cxr with interp                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01740  Anesth upper arm surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01742  Anesth humerus surgery                            J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01744  Anesth humerus repair                             J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0175T  Cad cxr remote                                    C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01756  Anesth radical humerus surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01758  Anesth humeral lesion surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01760  Anesth elbow replacement                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01770  Anesth uppr arm artery surg                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01772  Anesth uppr arm embolectomy                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0178T  64 lead ecg w/i&r                                 C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  4XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
01780  Anesth upper arm vein surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01782  Anesth uppr arm vein repair                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0179T  64 lead ecg w/tracing                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
0180T  64 lead ecg w/i&r only                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0181T  Corneal hysteresis                                C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01810  Anesth lower arm surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0182T  Hdr elect brachytherapy                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0182TTCHdr elect brachytherapy                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0182T26Hdr elect brachytherapy                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01820  Anesth lower arm procedure                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01829  Anesth dx wrist arthroscopy                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0183T  Wound ultrasound                                  C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01830  Anesth lower arm surgery                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01832  Anesth wrist replacement                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0184T  Exc rectal tumor endoscopic                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01840  Anesth lwr arm artery surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01842  Anesth lwr arm embolectomy                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01844  Anesth vascular shunt surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0185T  Comptr probability analysis                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01850  Anesth lower arm vein surg                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01852  Anesth lwr arm vein repair                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0186T  Suprachoroidal drug delivery                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01860  Anesth lower arm casting                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0188T  Videoconf crit care 74 min                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0189T  Videoconf crit care addl 30                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0190T  Place intraoc radiation src                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0191T  Insert ant segment drain int                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01916  Anesth dx arteriography                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0192T  Insert ant segment drain ext                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01920  Anesth catheterize heart                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01922  Anesth cat or mri scan                            J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01924  Anes ther interven rad art                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01925  Anes ther interven rad car                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01926  Anes tx interv rad hrt/cran                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01930  Anes ther interven rad vei                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01931  Anes ther interven rad tip                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01932  Anes tx interv rad th vein                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01933  Anes tx interv rad cran v                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01935  Anesth perc img dx sp proc                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01936  Anesth perc img tx sp proc                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0195T  Arthrod presac interbody                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01951  Anesth burn less 4 percent                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01952  Anesth burn 4-9 percent                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01953  Anesth burn each 9 percent                        J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01958  Anesth antepartum manipul                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0196T  Arthrod presac interbody eac                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01960  Anesth vaginal delivery                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01961  Anesth cs delivery                                J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01962  Anesth emer hysterectomy                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01963  Anesth cs hysterectomy                            J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01965  Anesth inc/missed ab proc                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01966  Anesth induced ab procedure                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01967  Anesth/analg vag delivery                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01968  Anes/analg cs deliver add-on                      J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01969  Anesth/analg cs hyst add-on                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0197T  Intrafraction track motion                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0198T  Ocular blood flow measure                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0199T  Physiologic tremor record                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
01990  Support for organ donor                           J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01991  Anesth nerve block/inj                            J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01992  Anesth n block/inj prone                          J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01996  Hosp manage cont drug admin                       J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
01999  Unlisted anesth procedure                         J   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0200T  Perq sacral augmt unilat inj                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0201T  Perq sacral augmt bilat inj                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
0202T  Post vert arthrplst 1 lumbar                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0205T  Inirs each vessel add-on                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0206T  Remote algorithm analys ecg                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0207T  Clear eyelid gland w/heat                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0208T  Audiometry air only                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0209T  Audiometry air & bone                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0210T  Speech audiometry threshold                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0211T  Speech audiom thresh & recog                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0212T  Compre audiometry evaluation                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0213T  Njx paravert w/us cer/thor                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0214T  Njx paravert w/us cer/thor                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0215T  Njx paravert w/us cer/thor                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0216T  Njx paravert w/us lumb/sac                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0217T  Njx paravert w/us lumb/sac                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0218T  Njx paravert w/us lumb/sac                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0219T  Plmt post facet implt cerv                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0220T  Plmt post facet implt thor                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0221T  Plmt post facet implt lumb                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0222T  Plmt post facet implt addl                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0223T  Acoustic ecg w/i&r                                C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0224T  Acoustic ecg 1+ analysis                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0225T  Acoustic ecg analy & reprog                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0226T  Anoscopy hra w/spec collect                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
0227T  Anoscopy hra w/biopsy                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
0228T  Njx tfrml eprl w/us cer/thor                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
0229T  Njx tfrml eprl w/us cer/thor                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
0230T  Njx tfrml eprl w/us lumb/sac                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
0231T  Njx tfrml eprl w/us lumb/sac                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
0232T  Njx platelet plasma                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
0233T  Skin glycation spectroscopy                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0234T  Trluml perip athrc renal art                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0235T  Trluml perip athrc visceral                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0236T  Trluml perip athrc abd aorta                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0237T  Trluml perip athrc brchiocph                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0238T  Trluml perip athrc iliac art                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0239T  Bioimpedance spectroscopy                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0240T  Esoph motility 3d topography                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0240TTCEsoph motility 3d topography                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0240T26Esoph motility 3d topography                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0241T  Esoph motility w/stim/perf                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0241TTCEsoph motility w/stim/perf                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0241T26Esoph motility w/stim/perf                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0242T  Gi tract transit & pres meas                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0242TTCGi tract transit & pres meas                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0242T26Gi tract transit & pres meas                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0243T  Intm msr bronchodil wheeze                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0243TTCIntm msr bronchodil wheeze                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0243T26Intm msr bronchodil wheeze                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0244T  Cont msr bronchodil wheeze                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0244TTCCont msr bronchodil wheeze                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0244T26Cont msr bronchodil wheeze                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0245T  Opn tx rib fx 1-2 ribs                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0246T  Opn tx rib fx 3-4 ribs                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0247T  Opn tx rib fx 5-6 ribs                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0248T  Opn tx rib fx 7+ ribs                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
0249T  Ligation hemorrhoid w/us                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0250T  Insert bronchial valve                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0251T  Remov bronchial valve addl                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0252T  Bronchscpc rmvl bronch valve                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0253T  Insert aqueous drain device                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0254T  Evasc rpr iliac art bifur                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0255T  Evasc rpr iliac art bifr s&i                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0255TTCEvasc rpr iliac art bifr s&i                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0255T26Evasc rpr iliac art bifr s&i                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0256T  Evasc aortic hrt valve                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0257T  Opn tthrc aortic hrt valve                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0258T  Aortic hrt valv w/o card byp                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0259T  Aortic hrt valve w/card byp                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0260T  Hypthrm bdy neonate 28d/<                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0261T  Hypthrm head neonate 28d/<                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
0500F  Initial prenatal care visit                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0501F  Prenatal flow sheet                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0502F  Subsequent prenatal care                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0503F  Postpartum care visit                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0505F  Hemodialysis plan docd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0507F  Periton dialysis plan docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0509F  Urine incon plan docd                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0513F  Elev bp plan of care docd                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0514F  Care plan hgb docd esa pt                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0516F  Anemia plan of care docd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0517F  Glaucoma plan of care docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0518F  Fall plan of care docd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0519F  Pland chemo docd b/4 txmnt                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0520F  Rad dos limts b/4 3d rad                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0521F  Plan of care 4 pain docd                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0525F  Initial visit for episode                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0526F  Subs visit for episode                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0528F  Rcmnd flw-up 10 yrs docd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0529F  Intrvl 3+yrs pts clnscp docd                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0535F  Dyspnea mngmnt plan docd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0540F  Gluco mngmnt plan docd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0545F  Follow up care plan mdd docd                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
0575F  HIV rna plan care docd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1000F  Tobacco use assessed                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1002F  Assess anginal symptom/level                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
10021  Fna w/o image                                     A   1.27   2.71     2.78     0.59     0.64     0.22   4.20   4.27   2.08   2.13  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
10022  Fna w/image                                       A   1.27   2.62     2.47     0.52     0.52     0.14   4.03   3.88   1.93   1.93  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
1003F  Level of activity assess                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1004F  Clin symp vol ovrld assess                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
10040  Acne surgery                                      A   1.21   1.60     1.65     1.23     1.29     0.18   2.99   3.04   2.62   2.68  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
1005F  Asthma symptoms evaluate                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1006F  Osteoarthritis assess                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
10060  Drainage of skin abscess                          A   1.22   1.87     2.00     1.37     1.46     0.12   3.21   3.34   2.71   2.80  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
10061  Drainage of skin abscess                          A   2.45   2.60     2.75     1.94     2.04     0.30   5.35   5.50   4.69   4.79  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
1007F  Anti-inflm/anlgsc otc assess                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1008F  Gi/renal risk assess                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
10080  Drainage of pilonidal cyst                        A   1.22   3.49     3.62     1.47     1.58     0.20   4.91   5.04   2.89   3.00  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
10081  Drainage of pilonidal cyst                        A   2.50   4.63     4.78     1.98     2.14     0.45   7.58   7.73   4.93   5.09  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
10120  Remove foreign body                               A   1.25   2.55     2.66     1.26     1.34     0.16   3.96   4.07   2.67   2.75  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
10121  Remove foreign body                               A   2.74   4.54     4.81     2.22     2.37     0.41   7.69   7.96   5.37   5.52  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
10140  Drainage of hematoma/fluid                        A   1.58   2.76     2.93     1.64     1.69     0.20   4.54   4.71   3.42   3.47  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
1015F  Copd symptoms assess                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
10160  Puncture drainage of lesion                       A   1.25   2.27     2.36     1.36     1.41     0.16   3.68   3.77   2.77   2.82  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
1018F  Assess dyspnea not present                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
10180  Complex drainage wound                            A   2.30   4.13     4.35     2.39     2.50     0.48   6.91   7.13   5.17   5.28  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
1019F  Assess dyspnea present                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1022F  Pneumo imm status assess                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1026F  Co-morbid condition assess                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1030F  Influenza imm status assess                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1034F  Current tobacco smoker                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1035F  Smokeless tobacco user                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1036F  Tobacco non-user                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1038F  Persistent asthma                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1039F  Intermittent asthma                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1040F  Dsm-iv info mdd docd                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1050F  History of mole changes                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1055F  Visual funct status assess                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1060F  Doc perm/cont/parox atr fib                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1061F  Doc lack perm+cont+parox fib                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1065F  Ischm stroke symp lt3 hrsb/4                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1066F  Ischm stroke symp ge3 hrsb/4                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1070F  Alarm symp assessed-absent                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1071F  Alarm symp assessed-1+ prsnt                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1090F  Pres/absn urine incon assess                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1091F  Urine incon characterized                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1100F  Ptfalls assess-docd ge2+/yr                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11000  Debride infected skin                             A   0.60   0.88     0.92     0.22     0.21     0.05   1.53   1.57   0.87   0.86  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11001  Debride infected skin add-on                      A   0.30   0.29     0.29     0.11     0.10     0.03   0.62   0.62   0.44   0.43  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
11004  Debride genitalia & perineum                      A  10.80   4.55NA   4.73NA   4.55     4.73     1.89  17.24  17.42  17.24  17.42  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11005  Debride abdom wall                                A  14.24   5.89NA   6.32NA   5.89     6.32     2.96  23.09  23.52  23.09  23.52  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
11006  Debride genit/per/abdom wall                      A  13.10   5.59NA   5.84NA   5.59     5.84     2.34  21.03  21.28  21.03  21.28  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11008  Remove mesh from abd wall                         A   5.00   2.07NA   2.21NA   2.07     2.21     1.05   8.12   8.26   8.12   8.26  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
1101F  Pt falls assess-docd le1/yr                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11010  Debride skin at fx site                           A   4.19   8.94     9.45     3.28     3.49     0.76  13.89  14.40   8.23   8.44  0010.10.80.1022100             25.5217 090 99      0.00   0.00   0.00
11011  Debride skin musc at fx site                      A   4.94   9.33     9.62     2.92     3.11     0.98  15.25  15.54   8.84   9.03  0000.00.00.0022100             25.5217 090 99      0.00   0.00   0.00
11012  Deb skin bone at fx site                          A   6.87  12.28    12.49     4.46     4.68     1.30  20.45  20.66  12.63  12.85  0000.00.00.0022100             25.5217 090 99      0.00   0.00   0.00
11042  Deb subq tissue 20 sq cm/<                        A   0.80   1.66     2.13     0.50     0.62     0.10   2.56   3.03   1.40   1.52  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11043  Deb musc/fascia 20 sq cm/<                        A   2.00   3.30     3.30     1.28     1.28     0.33   5.63   5.63   3.61   3.61  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11044  Deb bone 20 sq cm/<                               A   3.60   4.34     4.34     2.03     2.03     0.62   8.56   8.56   6.25   6.25  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11045  Deb subq tissue add-on                            A   0.33   0.51     0.51     0.13     0.13     0.07   0.91   0.91   0.53   0.53  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
11046  Deb musc/fascia add-on                            A   0.70   0.77     0.77     0.31     0.31     0.12   1.59   1.59   1.13   1.13  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
11047  Deb bone add-on                                   A   1.20   1.19     1.19     0.54     0.54     0.22   2.61   2.61   1.96   1.96  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
11055  Trim skin lesion                                  R   0.43   0.95     1.01     0.14     0.13     0.03   1.41   1.47   0.60   0.59  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11056  Trim skin lesions 2 to 4                          R   0.61   1.04     1.09     0.20     0.18     0.04   1.69   1.74   0.85   0.83  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11057  Trim skin lesions over 4                          R   0.79   1.17     1.23     0.26     0.24     0.05   2.01   2.07   1.10   1.08  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
1110F  Pt lft inpt fac w/in 60 days                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11100  Biopsy skin lesion                                A   0.81   2.10     2.10     0.54     0.59     0.11   3.02   3.02   1.46   1.51  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11101  Biopsy skin add-on                                A   0.41   0.50     0.51     0.28     0.30     0.05   0.96   0.97   0.74   0.76  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
1111F  Dschrg med/current med merge                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1116F  Auric/peri pain assessed                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1118F  GERD symps assessed 12 month                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1119F  Init eval for condition                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11200  Removal of skin tags                              A   0.82   1.53     1.61     1.15     1.22     0.11   2.46   2.54   2.08   2.15  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11201  Remove skin tags add-on                           A   0.29   0.22     0.24     0.17     0.18     0.04   0.55   0.57   0.50   0.51  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
1121F  Subs eval for condition                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1123F  Acp discuss/dscn mkr docd                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1124F  Acp discuss-no dscnmkr docd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1125F  Amnt pain noted pain prsnt                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1126F  Amnt pain noted none prsnt                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1130F  Bk pain + fxn assessed                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11300  Shave skin lesion                                 A   0.51   1.42     1.45     0.30     0.33     0.07   2.00   2.03   0.88   0.91  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11301  Shave skin lesion                                 A   0.85   1.75     1.78     0.54     0.59     0.11   2.71   2.74   1.50   1.55  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11302  Shave skin lesion                                 A   1.05   2.05     2.08     0.68     0.75     0.14   3.24   3.27   1.87   1.94  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11303  Shave skin lesion                                 A   1.24   2.40     2.45     0.79     0.87     0.18   3.82   3.87   2.21   2.29  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11305  Shave skin lesion                                 A   0.67   1.27     1.32     0.27     0.26     0.05   1.99   2.04   0.99   0.98  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11306  Shave skin lesion                                 A   0.99   1.67     1.71     0.51     0.52     0.11   2.77   2.81   1.61   1.62  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11307  Shave skin lesion                                 A   1.14   2.00     2.04     0.65     0.68     0.14   3.28   3.32   1.93   1.96  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11308  Shave skin lesion                                 A   1.41   2.08     2.15     0.68     0.70     0.14   3.63   3.70   2.23   2.25  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11310  Shave skin lesion                                 A   0.73   1.64     1.66     0.45     0.49     0.10   2.47   2.49   1.28   1.32  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11311  Shave skin lesion                                 A   1.05   1.92     1.95     0.69     0.74     0.14   3.11   3.14   1.88   1.93  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11312  Shave skin lesion                                 A   1.20   2.23     2.27     0.79     0.86     0.18   3.61   3.65   2.17   2.24  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
11313  Shave skin lesion                                 A   1.62   2.64     2.69     1.04     1.14     0.24   4.50   4.55   2.90   3.00  0000.00.00.0029000             25.5217 090 99      0.00   0.00   0.00
1134F  Epsd bk pain for =< 6 wks                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1135F  Epsd bk pain for > 6 wks                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1136F  Epsd bk pain for <= 12 wks                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1137F  Epsd bk pain for > 12 wks                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11400  Exc tr-ext b9+marg 0.5 < cm                       A   0.90   2.43     2.50     1.23     1.32     0.12   3.45   3.52   2.25   2.34  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11401  Exc tr-ext b9+marg 0.6-1 cm                       A   1.28   2.74     2.83     1.50     1.61     0.20   4.22   4.31   2.98   3.09  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11402  Exc tr-ext b9+marg 1.1-2 cm                       A   1.45   3.01     3.11     1.59     1.71     0.24   4.70   4.80   3.28   3.40  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11403  Exc tr-ext b9+marg 2.1-3 cm                       A   1.84   3.25     3.40     2.04     2.20     0.31   5.40   5.55   4.19   4.35  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11404  Exc tr-ext b9+marg 3.1-4 cm                       A   2.11   3.66     3.83     2.16     2.33     0.37   6.14   6.31   4.64   4.81  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11406  Exc tr-ext b9+marg > 4.0 cm                       A   3.52   4.57     4.90     2.81     3.10     0.67   8.76   9.09   7.00   7.29  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11420  Exc h-f-nk-sp b9+marg 0.5 <                       A   1.03   2.29     2.38     1.20     1.26     0.12   3.44   3.53   2.35   2.41  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11421  Exc h-f-nk-sp b9+marg 0.6-1                       A   1.47   2.78     2.89     1.52     1.62     0.22   4.47   4.58   3.21   3.31  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11422  Exc h-f-nk-sp b9+marg 1.1-2                       A   1.68   3.04     3.16     1.96     2.09     0.26   4.98   5.10   3.90   4.03  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11423  Exc h-f-nk-sp b9+marg 2.1-3                       A   2.06   3.38     3.51     2.15     2.30     0.33   5.77   5.90   4.54   4.69  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11424  Exc h-f-nk-sp b9+marg 3.1-4                       A   2.48   3.75     3.90     2.30     2.46     0.41   6.64   6.79   5.19   5.35  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11426  Exc h-f-nk-sp b9+marg > 4 cm                      A   4.09   4.69     4.95     3.11     3.38     0.71   9.49   9.75   7.91   8.18  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11440  Exc face-mm b9+marg 0.5 < cm                      A   1.05   2.59     2.66     1.72     1.82     0.16   3.80   3.87   2.93   3.03  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11441  Exc face-mm b9+marg 0.6-1 cm                      A   1.53   3.02     3.12     2.02     2.14     0.24   4.79   4.89   3.79   3.91  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11442  Exc face-mm b9+marg 1.1-2 cm                      A   1.77   3.33     3.45     2.16     2.29     0.29   5.39   5.51   4.22   4.35  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11443  Exc face-mm b9+marg 2.1-3 cm                      A   2.34   3.71     3.86     2.46     2.63     0.38   6.43   6.58   5.18   5.35  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11444  Exc face-mm b9+marg 3.1-4 cm                      A   3.19   4.37     4.57     2.90     3.12     0.52   8.08   8.28   6.61   6.83  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11446  Exc face-mm b9+marg > 4 cm                        A   4.80   5.52     5.95     3.82     4.21     0.80  11.12  11.55   9.42   9.81  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11450  Removal sweat gland lesion                        A   3.22   6.66     7.05     3.21     3.53     0.65  10.53  10.92   7.08   7.40  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
11451  Removal sweat gland lesion                        A   4.43   8.13     8.44     3.84     4.18     0.90  13.46  13.77   9.17   9.51  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
11462  Removal sweat gland lesion                        A   3.00   6.74     7.05     3.20     3.49     0.60  10.34  10.65   6.80   7.09  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
11463  Removal sweat gland lesion                        A   4.43   8.42     8.65     4.00     4.33     0.88  13.73  13.96   9.31   9.64  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
11470  Removal sweat gland lesion                        A   3.74   7.06     7.54     3.54     3.91     0.71  11.51  11.99   7.99   8.36  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
11471  Removal sweat gland lesion                        A   4.89   8.44     8.92     4.09     4.51     0.91  14.24  14.72   9.89  10.31  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
1150F  Doc pt rsk death w/in 1yr                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1151F  Doc no pt rsk death w/in 1yr                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1152F  Doc advncd dis comfort 1st                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1153F  Doc advncd dis cmfrt not 1st                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1157F  Advnc care plan in rcrd                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1158F  Advnc care plan tlk docd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1159F  Med list docd in rcrd                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
1160F  Rvw meds by rx/dr in rcrd                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11600  Exc tr-ext mlg+marg 0.5 < cm                      A   1.63   3.49     3.66     1.53     1.68     0.26   5.38   5.55   3.42   3.57  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11601  Exc tr-ext mlg+marg 0.6-1 cm                      A   2.07   4.15     4.29     1.97     2.12     0.31   6.53   6.67   4.35   4.50  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11602  Exc tr-ext mlg+marg 1.1-2 cm                      A   2.27   4.54     4.66     2.18     2.35     0.34   7.15   7.27   4.79   4.96  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11603  Exc tr-ext mlg+marg 2.1-3 cm                      A   2.82   4.88     5.07     2.45     2.68     0.42   8.12   8.31   5.69   5.92  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11604  Exc tr-ext mlg+marg 3.1-4 cm                      A   3.17   5.31     5.54     2.57     2.83     0.52   9.00   9.23   6.26   6.52  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11606  Exc tr-ext mlg+marg > 4 cm                        A   5.02   6.85     7.32     3.35     3.77     0.88  12.75  13.22   9.25   9.67  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11620  Exc h-f-nk-sp mlg+marg 0.5 <                      A   1.64   3.57     3.72     1.58     1.73     0.26   5.47   5.62   3.48   3.63  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11621  Exc h-f-nk-sp mlg+marg 0.6-1                      A   2.08   4.20     4.34     2.00     2.15     0.31   6.59   6.73   4.39   4.54  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11622  Exc h-f-nk-sp mlg+marg 1.1-2                      A   2.41   4.64     4.76     2.28     2.44     0.37   7.42   7.54   5.06   5.22  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11623  Exc h-f-nk-sp mlg+marg 2.1-3                      A   3.11   5.07     5.27     2.62     2.86     0.49   8.67   8.87   6.22   6.46  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11624  Exc h-f-nk-sp mlg+marg 3.1-4                      A   3.62   5.52     5.77     2.82     3.09     0.60   9.74   9.99   7.04   7.31  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11626  Exc h-f-nk-sp mlg+mar > 4 cm                      A   4.61   6.36     6.67     3.27     3.55     0.80  11.77  12.08   8.68   8.96  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11640  Exc face-mm malig+marg 0.5 <                      A   1.67   3.76     3.89     1.70     1.84     0.26   5.69   5.82   3.63   3.77  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11641  Exc face-mm malig+marg 0.6-1                      A   2.17   4.38     4.48     2.13     2.26     0.33   6.88   6.98   4.63   4.76  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11642  Exc face-mm malig+marg 1.1-2                      A   2.62   4.87     4.98     2.44     2.60     0.39   7.88   7.99   5.45   5.61  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11643  Exc face-mm malig+marg 2.1-3                      A   3.42   5.32     5.51     2.85     3.08     0.54   9.28   9.47   6.81   7.04  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11644  Exc face-mm malig+marg 3.1-4                      A   4.34   6.39     6.65     3.40     3.67     0.71  11.44  11.70   8.45   8.72  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11646  Exc face-mm mlg+marg > 4 cm                       A   6.26   7.67     8.06     4.46     4.82     1.05  14.98  15.37  11.77  12.13  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
1170F  Fxnl status assessed                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11719  Trim nail(s)                                      R   0.17   0.44     0.47     0.06     0.05     0.01   0.62   0.65   0.24   0.23  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11720  Debride nail 1-5                                  A   0.32   0.55     0.58     0.10     0.10     0.03   0.90   0.93   0.45   0.45  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
11721  Debride nail 6 or more                            A   0.54   0.65     0.67     0.18     0.16     0.04   1.23   1.25   0.76   0.74  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
11730  Removal of nail plate                             A   1.10   1.59     1.66     0.36     0.34     0.08   2.77   2.84   1.54   1.52  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11732  Remove nail plate add-on                          A   0.57   0.65     0.68     0.19     0.17     0.04   1.26   1.29   0.80   0.78  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
11740  Drain blood from under nail                       A   0.37   0.94     1.00     0.52     0.54     0.03   1.34   1.40   0.92   0.94  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11750  Removal of nail bed                               A   2.50   3.54     3.75     2.31     2.38     0.22   6.26   6.47   5.03   5.10  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11752  Remove nail bed/finger tip                        A   3.63   5.00     5.39     3.59     3.71     0.39   9.02   9.41   7.61   7.73  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11755  Biopsy nail unit                                  A   1.31   2.40     2.49     0.94     0.94     0.11   3.82   3.91   2.36   2.36  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11760  Repair of nail bed                                A   1.63   4.32     4.71     1.95     2.03     0.26   6.21   6.60   3.84   3.92  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11762  Reconstruction of nail bed                        A   2.94   4.56     4.88     2.25     2.23     0.31   7.81   8.13   5.50   5.48  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11765  Excision of nail fold toe                         A   0.74   3.15     3.37     1.20     1.27     0.05   3.94   4.16   1.99   2.06  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11770  Removal of pilonidal lesion                       A   2.66   4.51     4.77     2.07     2.26     0.52   7.69   7.95   5.25   5.44  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
11771  Removal of pilonidal lesion                       A   6.09   8.61     9.28     5.00     5.47     1.24  15.94  16.61  12.33  12.80  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
11772  Removal of pilonidal lesion                       A   7.35  10.30    10.92     7.27     7.83     1.47  19.12  19.74  16.09  16.65  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
1180F  Thromboemb risk assessed                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11900  Injection into skin lesions                       A   0.52   1.04     1.04     0.34     0.38     0.07   1.63   1.63   0.93   0.97  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11901  Added skin lesions injection                      A   0.80   1.16     1.18     0.54     0.59     0.11   2.07   2.09   1.45   1.50  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11920  Correct skin color defects                        R   1.61   3.21     3.13     1.48     1.59     0.31   5.13   5.05   3.40   3.51  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11921  Correct skin color defects                        R   1.93   3.62     3.60     1.71     1.85     0.37   5.92   5.90   4.01   4.15  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11922  Correct skin color defects                        R   0.49   1.20     1.23     0.32     0.35     0.08   1.77   1.80   0.89   0.92  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
11950  Therapy for contour defects                       R   0.84   1.13     1.05     0.49     0.49     0.10   2.07   1.99   1.43   1.43  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11951  Therapy for contour defects                       R   1.19   1.50     1.51     0.69     0.75     0.24   2.93   2.94   2.12   2.18  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11952  Therapy for contour defects                       R   1.69   1.85     1.62     0.88     0.81     0.24   3.78   3.55   2.81   2.74  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11954  Therapy for contour defects                       R   1.85   2.50     2.57     1.24     1.39     0.35   4.70   4.77   3.44   3.59  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11960  Insert tissue expander(s)                         A  11.49  13.07NA  13.05NA  13.07    13.05     1.83  26.39  26.37  26.39  26.37  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
11970  Replace tissue expander                           A   8.01   8.36NA   9.04NA   8.36     9.04     1.56  17.93  18.61  17.93  18.61  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
11971  Remove tissue expander(s)                         A   3.41   9.48     9.50     5.10     5.37     0.64  13.53  13.55   9.15   9.42  0090.10.71.1921000             25.5217 090 99      0.00   0.00   0.00
11975  Insert contraceptive cap                          N+  1.48   2.12     2.14     0.65     0.65     0.10   3.70   3.72   2.23   2.23  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11976  Removal of contraceptive cap                      R   1.78   2.17     2.14     0.75     0.83     0.30   4.25   4.22   2.83   2.91  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11977  Removal/reinsert contra cap                       N+  3.30   2.97     2.97     1.43     1.45     0.24   6.51   6.51   4.97   4.99  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
11980  Implant hormone pellet(s)                         A   1.48   1.34     1.37     0.68     0.73     0.23   3.05   3.08   2.39   2.44  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
11981  Insert drug implant device                        A   1.48   2.22     2.18     0.74     0.71     0.24   3.94   3.90   2.46   2.43  0XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11982  Remove drug implant device                        A   1.78   2.37     2.24     0.90     0.84     0.24   4.39   4.26   2.92   2.86  0XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
11983  Remove/insert drug implant                        A   3.30   2.87     2.55     1.56     1.36     0.35   6.52   6.20   5.21   5.01  0XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
1200F  Seizure type& frequ docd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
12001  Repair superficial wound(s)                       A   0.84   1.84     1.52     0.64     0.38     0.14   2.82   2.50   1.62   1.36  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12002  Repair superficial wound(s)                       A   1.14   1.98     1.72     0.75     0.46     0.19   3.31   3.05   2.08   1.79  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12004  Repair superficial wound(s)                       A   1.44   2.25     1.92     0.85     0.55     0.24   3.93   3.60   2.53   2.23  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12005  Repair superficial wound(s)                       A   1.97   2.76     2.39     1.03     0.73     0.33   5.06   4.69   3.33   3.03  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12006  Repair superficial wound(s)                       A   2.39   3.31     2.87     1.27     0.91     0.41   6.11   5.67   4.07   3.71  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12007  Repair superficial wound(s)                       A   2.90   3.72     3.20     1.50     1.07     0.50   7.12   6.60   4.90   4.47  0000.00.00.0020110             25.5217 090 99      0.00   0.00   0.00
12011  Repair superficial wound(s)                       A   1.07   2.12     1.87     0.68     0.43     0.19   3.38   3.13   1.94   1.69  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12013  Repair superficial wound(s)                       A   1.22   2.21     1.88     0.77     0.46     0.20   3.63   3.30   2.19   1.88  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12014  Repair superficial wound(s)                       A   1.57   2.47     2.08     0.89     0.57     0.26   4.30   3.91   2.72   2.40  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12015  Repair superficial wound(s)                       A   1.98   2.96     2.46     1.03     0.67     0.33   5.27   4.77   3.34   2.98  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12016  Repair superficial wound(s)                       A   2.68   3.45     2.92     1.29     0.91     0.46   6.59   6.06   4.43   4.05  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
12017  Repair superficial wound(s)                       A   3.18   1.34NA   0.76NA   1.34     0.76     0.56   5.08   4.50   5.08   4.50  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
12018  Repair superficial wound(s)                       A   3.61   1.78NA   0.85NA   1.78     0.85     0.64   6.03   5.10   6.03   5.10  0000.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
12020  Closure of split wound                            A   2.67   4.73     4.93     2.34     2.47     0.42   7.82   8.02   5.43   5.56  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12021  Closure of split wound                            A   1.89   2.45     2.63     1.80     1.94     0.31   4.65   4.83   4.00   4.14  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12031  Intmd wnd repair s/tr/ext                         A   2.20   4.53     4.76     2.20     2.41     0.35   7.08   7.31   4.75   4.96  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12032  Intmd wnd repair s/tr/ext                         A   2.52   6.01     6.07     2.84     2.98     0.38   8.91   8.97   5.74   5.88  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12034  Intmd wnd repair s/tr/ext                         A   2.97   5.42     5.65     2.52     2.72     0.50   8.89   9.12   5.99   6.19  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12035  Intmd wnd repair s/tr/ext                         A   3.47   6.68     6.90     2.82     2.98     0.64  10.79  11.01   6.93   7.09  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12036  Intmd wnd repair s/tr/ext                         A   4.09   6.92     7.24     3.06     3.26     0.77  11.78  12.10   7.92   8.12  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12037  Intmd wnd repair s/tr/ext                         A   4.71   7.60     7.90     3.59     3.78     0.90  13.21  13.51   9.20   9.39  0010.10.80.1020010             25.5217 090 99      0.00   0.00   0.00
12041  Intmd wnd repair n-hf/genit                       A   2.42   4.60     4.86     2.25     2.47     0.37   7.39   7.65   5.04   5.26  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12042  Intmd wnd repair n-hg/genit                       A   2.79   5.26     5.38     2.67     2.86     0.41   8.46   8.58   5.87   6.06  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12044  Intmd wnd repair n-hg/genit                       A   3.19   6.32     6.72     2.53     2.71     0.52  10.03  10.43   6.24   6.42  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12045  Intmd wnd repair n-hg/genit                       A   3.68   6.44     6.61     2.79     2.92     0.62  10.74  10.91   7.09   7.22  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12046  Intmd wnd repair n-hg/genit                       A   4.29   7.62     7.79     3.30     3.46     0.84  12.75  12.92   8.43   8.59  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
12047  Intmd wnd repair n-hg/genit                       A   4.69   8.24     8.60     3.48     3.52     0.91  13.84  14.20   9.08   9.12  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
1205F  EPI etiol synd rvwd and docd                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
12051  Intmd wnd repair face/mm                          A   2.52   4.91     5.04     2.45     2.63     0.39   7.82   7.95   5.36   5.54  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12052  Intmd wnd repair face/mm                          A   2.87   5.63     5.79     3.11     3.36     0.42   8.92   9.08   6.40   6.65  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12053  Intmd wnd repair face/mm                          A   3.17   6.19     6.45     2.69     2.89     0.50   9.86  10.12   6.36   6.56  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12054  Intmd wnd repair face/mm                          A   3.50   6.37     6.70     2.60     2.77     0.58  10.45  10.78   6.68   6.85  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12055  Intmd wnd repair face/mm                          A   4.47   7.35     7.83     2.80     2.98     0.73  12.55  13.03   8.00   8.18  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
12056  Intmd wnd repair face/mm                          A   5.28   9.02     9.98     4.14     4.87     0.67  14.97  15.93  10.09  10.82  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
12057  Intmd wnd repair face/mm                          A   6.00  10.32    11.66     4.41     4.79     0.76  17.08  18.42  11.17  11.55  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
1220F  Pt screened for depression                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
13100  Repair of wound or lesion                         A   3.17   5.47     5.52     3.24     3.38     0.50   9.14   9.19   6.91   7.05  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
13101  Repair of wound or lesion                         A   3.96   7.04     7.14     3.86     4.05     0.61  11.61  11.71   8.43   8.62  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
13102  Repair wound/lesion add-on                        A   1.24   1.69     1.77     0.76     0.84     0.23   3.16   3.24   2.23   2.31  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
13120  Repair of wound or lesion                         A   3.35   5.63     5.70     3.37     3.54     0.52   9.50   9.57   7.24   7.41  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
13121  Repair of wound or lesion                         A   4.42   7.85     8.00     4.58     4.83     0.67  12.94  13.09   9.67   9.92  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
13122  Repair wound/lesion add-on                        A   1.44   1.79     1.85     0.85     0.94     0.26   3.49   3.55   2.55   2.64  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
13131  Repair of wound or lesion                         A   3.83   6.08     6.17     3.74     3.91     0.58  10.49  10.58   8.15   8.32  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
13132  Repair of wound or lesion                         A   6.58   9.44     9.71     6.37     6.71     0.98  17.00  17.27  13.93  14.27  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
13133  Repair wound/lesion add-on                        A   2.19   2.40     2.51     1.41     1.53     0.34   4.93   5.04   3.94   4.06  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
13150  Repair of wound or lesion                         A   3.85   5.97     6.09     3.65     3.86     0.61  10.43  10.55   8.11   8.32  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
13151  Repair of wound or lesion                         A   4.49   6.73     6.85     4.25     4.44     0.67  11.89  12.01   9.41   9.60  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
13152  Repair of wound or lesion                         A   6.37   9.11     9.35     5.31     5.58     0.95  16.43  16.67  12.63  12.90  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
13153  Repair wound/lesion add-on                        A   2.38   2.65     2.79     1.49     1.63     0.38   5.41   5.55   4.25   4.39  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
13160  Late closure of wound                             A  12.04   9.45NA  10.04NA   9.45    10.04     2.23  23.72  24.31  23.72  24.31  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
1400F  Prkns diag rviewed                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
14000  Skin tissue rearrangement                         A   6.37  10.69    11.00     7.41     7.75     1.13  18.19  18.50  14.91  15.25  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
14001  Skin tissue rearrangement                         A   8.78  13.17    13.56     9.26     9.63     1.53  23.48  23.87  19.57  19.94  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
14020  Skin tissue rearrangement                         A   7.22  11.99    12.33     8.53     8.86     1.21  20.42  20.76  16.96  17.29  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
14021  Skin tissue rearrangement                         A   9.72  14.39    14.81    10.39    10.73     1.55  25.66  26.08  21.66  22.00  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
14040  Skin tissue rearrangement                         A   8.60  12.59    12.97     9.16     9.49     1.32  22.51  22.89  19.08  19.41  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
14041  Skin tissue rearrangement                         A  10.83  15.46    15.86    11.06    11.44     1.62  27.91  28.31  23.51  23.89  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
14060  Skin tissue rearrangement                         A   9.23  12.23    12.69     9.54     9.97     1.41  22.87  23.33  20.18  20.61  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
14061  Skin tissue rearrangement                         A  11.48  16.76    17.19    11.91    12.31     1.71  29.95  30.38  25.10  25.50  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
14301  Skin tissue rearrangement                         A  12.65  17.55    17.55    12.30    12.30     2.13  32.33  32.33  27.08  27.08  0090.10.71.1920200             25.5217 090 99      0.00   0.00   0.00
14302  Skin tissue rearrange add-on                      A   3.73   2.55     2.55     2.55     2.55     0.62   6.90   6.90   6.90   6.90  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
14350  Skin tissue rearrangement                         A  11.05   8.61NA   8.71NA   8.61     8.71     1.55  21.21  21.31  21.21  21.31  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15002  Wound prep trk/arm/leg                            A   3.65   5.50     5.85     2.37     2.60     0.65   9.80  10.15   6.67   6.90  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
15003  Wound prep addl 100 cm                            A   0.80   1.17     1.23     0.38     0.42     0.16   2.13   2.19   1.34   1.38  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
15004  Wound prep f/n/hf/g                               A   4.58   6.27     6.51     2.82     3.00     0.67  11.52  11.76   8.07   8.25  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
15005  Wnd prep f/n/hf/g addl cm                         A   1.60   1.63     1.74     0.76     0.86     0.31   3.54   3.65   2.67   2.77  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
15040  Harvest cultured skin graft                       A   2.00   5.01     5.05     1.38     1.46     0.37   7.38   7.42   3.75   3.83  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15050  Skin pinch graft                                  A   5.57   9.81    10.51     6.67     7.12     0.90  16.28  16.98  13.14  13.59  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15100  Skin splt grft trnk/arm/leg                       A   9.90  13.30    13.66     9.26     9.80     1.94  25.14  25.50  21.10  21.64  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15101  Skin splt grft t/a/l add-on                       A   1.72   3.37     3.34     1.23     1.28     0.34   5.43   5.40   3.29   3.34  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15110  Epidrm autogrft trnk/arm/leg                      A  10.97  11.67    12.19     8.51     9.12     2.15  24.79  25.31  21.63  22.24  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15111  Epidrm autogrft t/a/l add-on                      A   1.85   1.23     1.22     0.88     0.90     0.38   3.46   3.45   3.11   3.13  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15115  Epidrm a-grft face/nck/hf/g                       A  11.28  12.06    12.90     9.17     9.87     1.85  25.19  26.03  22.30  23.00  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15116  Epidrm a-grft f/n/hf/g addl                       A   2.50   1.98     2.24     1.55     1.81     0.49   4.97   5.23   4.54   4.80  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
15120  Skn splt a-grft fac/nck/hf/g                      A  11.16  14.69    15.60    10.17    10.93     1.93  27.78  28.69  23.26  24.02  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15121  Skn splt a-grft f/n/hf/g add                      A   2.67   4.60     4.71     1.88     2.02     0.50   7.77   7.88   5.05   5.19  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
15130  Derm autograft trnk/arm/leg                       A   7.53  10.66    11.04     7.56     8.03     1.48  19.67  20.05  16.57  17.04  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15131  Derm autograft t/a/l add-on                       A   1.50   1.17     1.31     0.91     1.08     0.31   2.98   3.12   2.72   2.89  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
15135  Derm autograft face/nck/hf/g                      A  11.03  12.46    13.33     9.62    10.31     1.87  25.36  26.23  22.52  23.21  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15136  Derm autograft f/n/hf/g add                       A   1.50   0.99     1.18     0.80     1.00     0.10   2.59   2.78   2.40   2.60  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
15150  Cult epiderm grft t/arm/leg                       A   9.39   8.84     8.97     7.17     7.32     1.98  20.21  20.34  18.54  18.69  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15151  Cult epiderm grft t/a/l addl                      A   2.00   1.46     1.67     1.17     1.41     0.42   3.88   4.09   3.59   3.83  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15152  Cult epiderm graft t/a/l +%                       A   2.50   1.56     1.38     1.27     1.12     0.49   4.55   4.37   4.26   4.11  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15155  Cult epiderm graft f/n/hf/g                       A  10.14   7.93     6.92     6.55     5.57     0.76  18.83  17.82  17.45  16.47  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15156  Cult epidrm grft f/n/hfg add                      A   2.75   1.62     1.47     1.35     1.20     0.58   4.95   4.80   4.68   4.53  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
15157  Cult epiderm grft f/n/hfg +%                      A   3.00   1.60     1.20     1.25     0.90     0.22   4.82   4.42   4.47   4.12  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
15170  Acell graft trunk/arms/legs                       A   5.99   5.58     6.09     3.81     4.27     1.09  12.66  13.17  10.89  11.35  0090.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
15171  Acell graft t/arm/leg add-on                      A   1.55   0.90     0.98     0.75     0.81     0.31   2.76   2.84   2.61   2.67  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15175  Acellular graft f/n/hf/g                          A   7.99   6.05     6.23     4.39     4.53     1.05  15.09  15.27  13.43  13.57  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15176  Acell graft f/n/hf/g add-on                       A   2.45   1.47     1.58     1.19     1.27     0.39   4.31   4.42   4.03   4.11  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
15200  Skin full graft trunk                             A   9.15  13.10    13.90     8.85     9.61     1.64  23.89  24.69  19.64  20.40  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15201  Skin full graft trunk add-on                      A   1.32   2.75     2.81     0.80     0.90     0.26   4.33   4.39   2.38   2.48  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
15220  Skin full graft sclp/arm/leg                      A   8.09  13.01    13.52     8.83     9.29     1.39  22.49  23.00  18.31  18.77  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15221  Skin full graft add-on                            A   1.19   2.59     2.62     0.74     0.80     0.23   4.01   4.04   2.16   2.22  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15240  Skin full grft face/genit/hf                      A  10.41  15.08    15.82    11.57    12.31     1.70  27.19  27.93  23.68  24.42  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15241  Skin full graft add-on                            A   1.86   3.21     3.34     1.19     1.30     0.33   5.40   5.53   3.38   3.49  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15260  Skin full graft een & lips                        A  11.64  16.07    16.83    12.20    12.89     1.77  29.48  30.24  25.61  26.30  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15261  Skin full graft add-on                            A   2.23   3.70     3.85     1.67     1.78     0.37   6.30   6.45   4.27   4.38  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15300  Apply skinallogrft t/arm/lg                       A   4.65   4.64     5.06     3.07     3.37     0.86  10.15  10.57   8.58   8.88  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15301  Apply sknallogrft t/a/l addl                      A   1.00   0.64     0.68     0.48     0.51     0.20   1.84   1.88   1.68   1.71  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15320  Apply skin allogrft f/n/hf/g                      A   5.36   4.79     4.98     3.08     3.18     0.73  10.88  11.07   9.17   9.27  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15321  Aply sknallogrft f/n/hfg add                      A   1.50   0.96     1.04     0.75     0.81     0.30   2.76   2.84   2.55   2.61  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
15330  Aply acell alogrft t/arm/leg                      A   3.99   4.69     5.11     3.07     3.37     0.76   9.44   9.86   7.82   8.12  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15331  Aply acell grft t/a/l add-on                      A   1.00   0.68     0.75     0.53     0.59     0.20   1.88   1.95   1.73   1.79  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15335  Apply acell graft f/n/hf/g                        A   4.50   4.27     4.45     2.71     2.80     0.50   9.27   9.45   7.71   7.80  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15336  Aply acell grft f/n/hf/g add                      A   1.43   1.07     1.33     0.80     1.03     0.10   2.60   2.86   2.33   2.56  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
15340  Apply cult skin substitute                        A   3.82   4.77     4.92     3.43     3.57     0.52   9.11   9.26   7.77   7.91  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
15341  Apply cult skin sub add-on                        A   0.50   0.79     0.82     0.20     0.20     0.07   1.36   1.39   0.77   0.77  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15360  Apply cult derm sub t/a/l                         A   4.02   5.77     5.87     4.23     4.35     0.60  10.39  10.49   8.85   8.97  0090.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
15361  Aply cult derm sub t/a/l add                      A   1.15   0.58     0.50     0.40     0.35     0.20   1.93   1.85   1.75   1.70  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15365  Apply cult derm sub f/n/hf/g                      A   4.30   5.22     5.33     3.82     3.92     0.41   9.93  10.04   8.53   8.63  0090.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
15366  Apply cult derm f/hf/g add                        A   1.45   0.76     0.76     0.54     0.53     0.16   2.37   2.37   2.15   2.14  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15400  Apply skin xenograft t/a/l                        A   4.47   6.62     7.12     5.24     5.53     0.69  11.78  12.28  10.40  10.69  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15401  Apply skn xenogrft t/a/l add                      A   1.00   1.43     1.37     0.48     0.51     0.22   2.65   2.59   1.70   1.73  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15420  Apply skin xgraft f/n/hf/g                        A   4.98   7.14     7.32     5.63     5.81     0.67  12.79  12.97  11.28  11.46  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15421  Apply skn xgrft f/n/hf/g add                      A   1.50   1.59     1.69     0.74     0.83     0.30   3.39   3.49   2.54   2.63  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15430  Apply acellular xenograft                         A   6.20   8.50     9.05     7.86     8.33     1.05  15.75  16.30  15.11  15.58  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15431  Apply acellular xgraft add                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
15570  Form skin pedicle flap                            A  10.21  13.78    14.44     9.00     9.67     2.06  26.05  26.71  21.27  21.94  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15572  Form skin pedicle flap                            A  10.12  13.46    14.40     9.73    10.64     1.82  25.40  26.34  21.67  22.58  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15574  Form skin pedicle flap                            A  10.70  14.04    14.86    10.11    10.89     1.82  26.56  27.38  22.63  23.41  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15576  Form skin pedicle flap                            A   9.37  12.68    13.32     9.01     9.67     1.53  23.58  24.22  19.91  20.57  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15600  Skin graft                                        A   2.01   7.07     6.99     3.63     3.78     0.38   9.46   9.38   6.02   6.17  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15610  Skin graft                                        A   2.52   6.96     7.38     4.07     4.25     0.45   9.93  10.35   7.04   7.22  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15620  Skin graft                                        A   3.75   8.41     8.51     5.11     5.41     0.61  12.77  12.87   9.47   9.77  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15630  Skin graft                                        A   4.08   8.77     8.89     5.54     5.78     0.65  13.50  13.62  10.27  10.51  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15650  Transfer skin pedicle flap                        A   4.77   9.37     9.41     5.89     6.08     0.77  14.91  14.95  11.43  11.62  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15731  Forehead flap w/vasc pedicle                      A  14.38  16.69    17.64    13.49    14.44     2.40  33.47  34.42  30.27  31.22  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15732  Muscle-skin graft head/neck                       A  19.90  20.64    21.93    15.98    17.57     3.53  44.07  45.36  39.41  41.00  0090.10.71.1920110             25.5217 090 99      0.00   0.00   0.00
15734  Muscle-skin graft trunk                           A  19.86  20.94    21.72    15.95    16.90     3.98  44.78  45.56  39.79  40.74  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15736  Muscle-skin graft arm                             A  17.04  19.02    19.70    13.87    14.92     3.35  39.41  40.09  34.26  35.31  0090.10.71.1920110             25.5217 090 99      0.00   0.00   0.00
15738  Muscle-skin graft leg                             A  19.04  19.11    19.76    14.31    15.25     3.80  41.95  42.60  37.15  38.09  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15740  Island pedicle flap graft                         A  11.80  16.48    17.12    12.17    12.82     1.77  30.05  30.69  25.74  26.39  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15750  Neurovascular pedicle graft                       A  12.96  11.76NA  12.53NA  11.76    12.53     2.28  27.00  27.77  27.00  27.77  0090.10.71.1920200             25.5217 090 99      0.00   0.00   0.00
15756  Free myo/skin flap microvasc                      A  36.94  26.64NA  29.02NA  26.64    29.02     6.34  69.92  72.30  69.92  72.30  0090.10.71.1920220             25.5217 090 99      0.00   0.00   0.00
15757  Free skin flap microvasc                          A  37.15  26.16NA  28.48NA  26.16    28.48     5.91  69.22  71.54  69.22  71.54  0090.10.71.1920220             25.5217 090 99      0.00   0.00   0.00
15758  Free fascial flap microvasc                       A  36.90  26.11NA  28.29NA  26.11    28.29     5.91  68.92  71.10  68.92  71.10  0090.10.71.1920220             25.5217 090 99      0.00   0.00   0.00
15760  Composite skin graft                              A   9.86  13.50    14.22     9.61    10.30     1.58  24.94  25.66  21.05  21.74  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15770  Derma-fat-fascia graft                            A   8.96   9.09NA   9.82NA   9.09     9.82     1.63  19.68  20.41  19.68  20.41  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15775  Hair transplant punch grafts                      R   3.95   4.18     3.84     1.98     2.00     0.29   8.42   8.08   6.22   6.24  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
15776  Hair transplant punch grafts                      R   5.53   6.42     6.64     3.17     3.38     0.38  12.33  12.55   9.08   9.29  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
15780  Abrasion treatment of skin                        A   8.73  14.09    14.19     8.65     8.63     1.20  24.02  24.12  18.58  18.56  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15781  Abrasion treatment of skin                        A   5.02  10.10    10.46     6.93     7.20     0.76  15.88  16.24  12.71  12.98  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15782  Abrasion treatment of skin                        A   4.44  11.08    10.83     6.61     6.40     0.62  16.14  15.89  11.67  11.46  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15783  Abrasion treatment of skin                        A   4.41   9.19     9.33     6.00     6.32     0.62  14.22  14.36  11.03  11.35  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15786  Abrasion lesion single                            A   2.08   4.64     4.72     1.68     1.75     0.33   7.05   7.13   4.09   4.16  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
15787  Abrasion lesions add-on                           A   0.33   1.02     1.01     0.15     0.16     0.04   1.39   1.38   0.52   0.53  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
15788  Chemical peel face epiderm                        R   2.09  10.62    11.13     4.79     5.07     0.35  13.06  13.57   7.23   7.51  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15789  Chemical peel face dermal                         R   4.91  10.79    10.76     6.94     7.14     0.68  16.38  16.35  12.53  12.73  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15792  Chemical peel nonfacial                           R   1.86  10.39    10.60     5.56     5.64     0.30  12.55  12.76   7.72   7.80  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15793  Chemical peel nonfacial                           A   3.96   9.66     9.99     6.20     6.51     0.56  14.18  14.51  10.72  11.03  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15819  Plastic surgery neck                              A  10.65   8.17NA   7.61NA   8.17     7.61     2.09  20.91  20.35  20.91  20.35  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15820  Revision of lower eyelid                          A   6.27   8.85     9.47     7.36     8.01     1.24  16.36  16.98  14.87  15.52  0090.10.71.1921000             25.5217 090 99      0.00   0.00   0.00
15821  Revision of lower eyelid                          A   6.84   9.28    10.06     7.62     8.41     1.33  17.45  18.23  15.79  16.58  0090.10.71.1921000             25.5217 090 99      0.00   0.00   0.00
15822  Revision of upper eyelid                          A   4.62   7.24     7.76     5.79     6.32     0.81  12.67  13.19  11.22  11.75  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
15823  Revision of upper eyelid                          A   6.81   9.79    10.15     8.16     8.49     1.26  17.86  18.22  16.23  16.56  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
15824  Removal of forehead wrinkles                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
15825  Removal of neck wrinkles                          R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
15826  Removal of brow wrinkles                          R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
15828  Removal of face wrinkles                          R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
15829  Removal of skin wrinkles                          R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
15830  Exc skin abd                                      R  17.11  13.81NA  15.13NA  13.81    15.13     3.38  34.30  35.62  34.30  35.62  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15832  Excise excessive skin tissue                      A  12.85  11.75NA  13.28NA  11.75    13.28     2.57  27.17  28.70  27.17  28.70  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15833  Excise excessive skin tissue                      A  11.90  11.29NA  12.59NA  11.29    12.59     2.32  25.51  26.81  25.51  26.81  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15834  Excise excessive skin tissue                      A  12.17  11.12NA  12.79NA  11.12    12.79     2.39  25.68  27.35  25.68  27.35  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15835  Excise excessive skin tissue                      A  12.99  11.63NA  13.35NA  11.63    13.35     2.55  27.17  28.89  27.17  28.89  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15836  Excise excessive skin tissue                      A  10.61   8.53NA   8.54NA   8.53     8.54     2.08  21.22  21.23  21.22  21.23  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15837  Excise excessive skin tissue                      A   9.55  12.66    14.51     8.94    10.04     2.01  24.22  26.07  20.50  21.60  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15838  Excise excessive skin tissue                      A   8.25   7.66NA   8.21NA   7.66     8.21     1.06  16.97  17.52  16.97  17.52  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15839  Excise excessive skin tissue                      A  10.50  12.77    13.50     8.92     9.54     1.93  25.20  25.93  21.35  21.97  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15840  Graft for face nerve palsy                        A  14.99  12.75NA  13.88NA  12.75    13.88     2.39  30.13  31.26  30.13  31.26  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15841  Graft for face nerve palsy                        A  25.99  20.42NA  22.89NA  20.42    22.89     3.35  49.76  52.23  49.76  52.23  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15842  Flap for face nerve palsy                         A  41.01  28.39NA  29.43NA  28.39    29.43     5.27  74.67  75.71  74.67  75.71  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15845  Skin and muscle repair face                       A  14.32  12.63NA  14.23NA  12.63    14.23     1.83  28.78  30.38  28.78  30.38  0090.10.71.1920200             25.5217 090 99      0.00   0.00   0.00
15847  Exc skin abd add-on                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
15850  Removal of sutures                                B+  0.78   1.68     1.61     0.34     0.34     0.05   2.51   2.44   1.17   1.17  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
15851  Removal of sutures                                A   0.86   1.78     1.85     0.37     0.42     0.12   2.76   2.83   1.35   1.40  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
15852  Dressing change not for burn                      A   0.86   0.39NA   0.42NA   0.39     0.42     0.14   1.39   1.42   1.39   1.42  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
15860  Test for blood flow in graft                      A   1.95   0.90NA   0.91NA   0.90     0.91     0.38   3.23   3.24   3.23   3.24  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
15876  Suction assisted lipectomy                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
15877  Suction assisted lipectomy                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
15878  Suction assisted lipectomy                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
15879  Suction assisted lipectomy                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
15920  Removal of tail bone ulcer                        A   8.29   7.57NA   8.22NA   7.57     8.22     1.71  17.57  18.22  17.57  18.22  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15922  Removal of tail bone ulcer                        A  10.38  10.22NA  11.56NA  10.22    11.56     2.02  22.62  23.96  22.62  23.96  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15931  Remove sacrum pressure sore                       A  10.07   7.52NA   8.08NA   7.52     8.08     2.06  19.65  20.21  19.65  20.21  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15933  Remove sacrum pressure sore                       A  11.77  10.18NA  10.93NA  10.18    10.93     2.40  24.35  25.10  24.35  25.10  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15934  Remove sacrum pressure sore                       A  13.68  10.61NA  11.55NA  10.61    11.55     2.77  27.06  28.00  27.06  28.00  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15935  Remove sacrum pressure sore                       A  15.78  13.09NA  13.98NA  13.09    13.98     3.18  32.05  32.94  32.05  32.94  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15936  Remove sacrum pressure sore                       A  13.16  10.30NA  11.15NA  10.30    11.15     2.66  26.12  26.97  26.12  26.97  0090.10.71.1920110             25.5217 090 99      0.00   0.00   0.00
15937  Remove sacrum pressure sore                       A  15.14  12.38NA  13.40NA  12.38    13.40     3.06  30.58  31.60  30.58  31.60  0090.10.71.1920110             25.5217 090 99      0.00   0.00   0.00
15940  Remove hip pressure sore                          A  10.20   7.99NA   8.67NA   7.99     8.67     2.06  20.25  20.93  20.25  20.93  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15941  Remove hip pressure sore                          A  12.41  11.39NA  12.12NA  11.39    12.12     2.47  26.27  27.00  26.27  27.00  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15944  Remove hip pressure sore                          A  12.44  11.20NA  12.18NA  11.20    12.18     2.50  26.14  27.12  26.14  27.12  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15945  Remove hip pressure sore                          A  13.75  12.52NA  13.62NA  12.52    13.62     2.73  29.00  30.10  29.00  30.10  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
15946  Remove hip pressure sore                          A  24.12  19.29NA  20.95NA  19.29    20.95     4.81  48.22  49.88  48.22  49.88  0090.10.71.1920110             25.5217 090 99      0.00   0.00   0.00
15950  Remove thigh pressure sore                        A   8.03   7.04NA   7.41NA   7.04     7.41     1.59  16.66  17.03  16.66  17.03  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
15951  Remove thigh pressure sore                        A  11.58  11.24NA  13.10NA  11.24    13.10     2.27  25.09  26.95  25.09  26.95  0090.10.71.1920010             25.5217 090 99      0.00   0.00   0.00
15952  Remove thigh pressure sore                        A  12.31   9.58NA   9.56NA   9.58     9.56     2.62  24.51  24.49  24.51  24.49  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
15953  Remove thigh pressure sore                        A  13.57  10.67NA  10.50NA  10.67    10.50     2.66  26.90  26.73  26.90  26.73  0090.10.71.1920110             25.5217 090 99      0.00   0.00   0.00
15956  Remove thigh pressure sore                        A  16.79  13.69NA  14.93NA  13.69    14.93     3.41  33.89  35.13  33.89  35.13  0090.10.71.1920110             25.5217 090 99      0.00   0.00   0.00
15958  Remove thigh pressure sore                        A  16.75  14.45NA  15.71NA  14.45    15.71     3.38  34.58  35.84  34.58  35.84  0090.10.71.1920110             25.5217 090 99      0.00   0.00   0.00
15999  Removal of pressure sore                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
16000  Initial treatment of burn(s)                      A   0.89   0.98     1.03     0.34     0.39     0.12   1.99   2.04   1.35   1.40  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
16020  Dress/debrid p-thick burn s                       A   0.80   1.48     1.57     0.76     0.82     0.11   2.39   2.48   1.67   1.73  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
16025  Dress/debrid p-thick burn m                       A   1.85   2.14     2.27     1.23     1.34     0.31   4.30   4.43   3.39   3.50  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
16030  Dress/debrid p-thick burn l                       A   2.08   2.72     2.87     1.41     1.53     0.37   5.17   5.32   3.86   3.98  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
16035  Incision of burn scab initi                       A   3.74   1.62NA   1.58NA   1.62     1.58     0.62   5.98   5.94   5.98   5.94  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
16036  Escharotomy addl incision                         A   1.50   0.65NA   0.67NA   0.65     0.67     0.27   2.42   2.44   2.42   2.44  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
17000  Destruct premalg lesion                           A   0.65   1.61     1.64     0.90     0.94     0.08   2.34   2.37   1.63   1.67  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17003  Destruct premalg les 2-14                         A   0.07   0.13     0.12     0.05     0.05     0.01   0.21   0.20   0.13   0.13  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
17004  Destroy premlg lesions 15+                        A   1.85   2.95     2.93     1.83     1.86     0.27   5.07   5.05   3.95   3.98  0010.10.80.1000100             25.5217 090 99      0.00   0.00   0.00
17106  Destruction of skin lesions                       A   3.69   5.78     5.87     3.93     4.04     0.53  10.00  10.09   8.15   8.26  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
17107  Destruction of skin lesions                       A   4.79   7.47     7.40     5.00     4.96     0.73  12.99  12.92  10.52  10.48  0090.10.71.1920100             25.5217 090 99      0.00   0.00   0.00
17108  Destruction of skin lesions                       A   7.49   9.74    10.10     6.68     6.88     1.30  18.53  18.89  15.47  15.67  0090.10.71.1920000             25.5217 090 99      0.00   0.00   0.00
17110  Destruct b9 lesion 1-14                           A   0.70   2.42     2.41     1.24     1.28     0.08   3.20   3.19   2.02   2.06  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17111  Destruct lesion 15 or more                        A   0.97   2.72     2.73     1.42     1.47     0.12   3.81   3.82   2.51   2.56  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17250  Chemical cautery tissue                           A   0.50   1.63     1.69     0.49     0.51     0.07   2.20   2.26   1.06   1.08  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
17260  Destruction of skin lesions                       A   0.96   1.69     1.70     0.92     0.97     0.12   2.77   2.78   2.00   2.05  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17261  Destruction of skin lesions                       A   1.22   2.79     2.80     1.33     1.39     0.18   4.19   4.20   2.73   2.79  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17262  Destruction of skin lesions                       A   1.63   3.21     3.24     1.61     1.69     0.23   5.07   5.10   3.47   3.55  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17263  Destruction of skin lesions                       A   1.84   3.49     3.52     1.74     1.84     0.26   5.59   5.62   3.84   3.94  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17264  Destruction of skin lesions                       A   1.99   3.70     3.74     1.82     1.92     0.29   5.98   6.02   4.10   4.20  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17266  Destruction of skin lesions                       A   2.39   4.05     4.11     2.04     2.18     0.34   6.78   6.84   4.77   4.91  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17270  Destruction of skin lesions                       A   1.37   2.79     2.84     1.39     1.47     0.20   4.36   4.41   2.96   3.04  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17271  Destruction of skin lesions                       A   1.54   3.02     3.06     1.54     1.62     0.23   4.79   4.83   3.31   3.39  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17272  Destruction of skin lesions                       A   1.82   3.38     3.42     1.74     1.83     0.26   5.46   5.50   3.82   3.91  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17273  Destruction of skin lesions                       A   2.10   3.69     3.73     1.91     2.02     0.30   6.09   6.13   4.31   4.42  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17274  Destruction of skin lesions                       A   2.64   4.17     4.22     2.25     2.37     0.37   7.18   7.23   5.26   5.38  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17276  Destruction of skin lesions                       A   3.25   4.58     4.68     2.57     2.73     0.48   8.31   8.41   6.30   6.46  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17280  Destruction of skin lesions                       A   1.22   2.69     2.72     1.29     1.36     0.18   4.09   4.12   2.69   2.76  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17281  Destruction of skin lesions                       A   1.77   3.15     3.19     1.70     1.79     0.26   5.18   5.22   3.73   3.82  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17282  Destruction of skin lesions                       A   2.09   3.61     3.67     1.92     2.03     0.30   6.00   6.06   4.31   4.42  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17283  Destruction of skin lesions                       A   2.69   4.15     4.23     2.30     2.44     0.38   7.22   7.30   5.37   5.51  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17284  Destruction of skin lesions                       A   3.26   4.66     4.75     2.66     2.81     0.45   8.37   8.46   6.37   6.52  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17286  Destruction of skin lesions                       A   4.48   5.44     5.62     3.38     3.58     0.67  10.59  10.77   8.53   8.73  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17311  Mohs 1 stage h/n/hf/g                             A   6.20  12.64    12.21     4.34     4.67     0.87  19.71  19.28  11.41  11.74  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
17312  Mohs addl stage                                   A   3.30   8.01     7.67     2.31     2.48     0.45  11.76  11.42   6.06   6.23  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
17313  Mohs 1 stage t/a/l                                A   5.56  11.64    11.23     3.90     4.19     0.77  17.97  17.56  10.23  10.52  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
17314  Mohs addl stage t/a/l                             A   3.06   7.43     7.11     2.14     2.30     0.42  10.91  10.59   5.62   5.78  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
17315  Mohs surg addl block                              A   0.87   1.38     1.36     0.61     0.66     0.11   2.36   2.34   1.59   1.64  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
17340  Cryotherapy of skin                               A   0.77   0.58     0.65     0.52     0.59     0.10   1.45   1.52   1.39   1.46  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17360  Skin peel therapy                                 A   1.46   2.19     2.21     1.31     1.38     0.22   3.87   3.89   2.99   3.06  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
17380  Hair removal by electrolysis                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
17999  Skin tissue procedure                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
19000  Drainage of breast lesion                         A   0.84   2.26     2.15     0.35     0.33     0.11   3.21   3.10   1.30   1.28  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
19001  Drain breast lesion add-on                        A   0.42   0.31     0.29     0.17     0.16     0.05   0.78   0.76   0.64   0.63  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
19020  Incision of breast lesion                         A   3.83   8.45     8.89     3.98     4.32     0.77  13.05  13.49   8.58   8.92  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19030  Injection for breast x-ray                        A   1.53   3.09     2.83     0.64     0.57     0.14   4.76   4.50   2.31   2.24  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
19100  Bx breast percut w/o image                        A   1.27   2.66     2.77     0.50     0.55     0.26   4.19   4.30   2.03   2.08  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
19101  Biopsy of breast open                             A   3.23   5.65     5.90     2.44     2.62     0.67   9.55   9.80   6.34   6.52  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
19102  Bx breast percut w/image                          A   2.00   4.06     3.73     0.83     0.76     0.22   6.28   5.95   3.05   2.98  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
19103  Bx breast percut w/device                         A   3.69  11.97    11.15     1.51     1.44     0.48  16.14  15.32   5.68   5.61  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
19105  Cryosurg ablate fa each                           A   3.69  56.05    49.38     1.61     1.62     0.39  60.13  53.46   5.69   5.70  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
19110  Nipple exploration                                A   4.44   8.19     8.74     4.30     4.69     0.92  13.55  14.10   9.66  10.05  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19112  Excise breast duct fistula                        A   3.81   8.12     8.61     4.15     4.52     0.80  12.73  13.22   8.76   9.13  0090.10.71.1921000             25.5217 090 99      0.00   0.00   0.00
19120  Removal of breast lesion                          A   5.92   6.65     7.17     4.55     4.98     1.25  13.82  14.34  11.72  12.15  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19125  Excision breast lesion                            A   6.69   7.23     7.83     4.93     5.41     1.41  15.33  15.93  13.03  13.51  0090.10.71.1921110             25.5217 090 99      0.00   0.00   0.00
19126  Excision addl breast lesion                       A   2.93   1.16NA   1.27NA   1.16     1.27     0.62   4.71   4.82   4.71   4.82  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
19260  Removal of chest wall lesion                      A  17.78  13.62NA  14.21NA  13.62    14.21     3.95  35.35  35.94  35.35  35.94  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
19271  Revision of chest wall                            A  22.19  20.72NA  20.98NA  20.72    20.98     5.04  47.95  48.21  47.95  48.21  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
19272  Extensive chest wall surgery                      A  25.17  21.98NA  22.11NA  21.98    22.11     5.95  53.10  53.23  53.10  53.23  0090.10.71.1920210             25.5217 090 99      0.00   0.00   0.00
19290  Place needle wire breast                          A   1.27   3.31     3.08     0.53     0.48     0.12   4.70   4.47   1.92   1.87  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
19291  Place needle wire breast                          A   0.63   1.32     1.22     0.26     0.24     0.05   2.00   1.90   0.94   0.92  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
19295  Place breast clip percut                          A   0.00   2.67     2.45     2.67NA   2.45 NA  0.01   2.68   2.46   2.68   2.46  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
19296  Place po breast cath for rad                      A   3.63 112.34   108.67     1.76     1.89     0.73 116.70 113.03   6.12   6.25  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
19297  Place breast cath for rad                         A   1.72   0.69NA   0.75NA   0.69     0.75     0.35   2.76   2.82   2.76   2.82  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
19298  Place breast rad tube/caths                       A   6.00  29.07    24.98     2.83     2.87     0.76  35.83  31.74   9.59   9.63  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
19300  Removal of breast tissue                          A   5.31   8.23     8.56     5.09     5.55     1.13  14.67  15.00  11.53  11.99  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19301  Partical mastectomy                               A  10.13   6.26NA   7.04NA   6.26     7.04     2.15  18.54  19.32  18.54  19.32  0090.10.71.1921000             25.5217 090 99      0.00   0.00   0.00
19302  P-mastectomy w/ln removal                         A  13.99   8.60NA   9.36NA   8.60     9.36     2.97  25.56  26.32  25.56  26.32  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19303  Mast simple complete                              A  15.85   9.47NA  10.70NA   9.47    10.70     3.37  28.69  29.92  28.69  29.92  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19304  Mast subq                                         A   7.95   6.71NA   7.34NA   6.71     7.34     1.67  16.33  16.96  16.33  16.96  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19305  Mast radical                                      A  17.46  11.23NA  12.34NA  11.23    12.34     3.72  32.41  33.52  32.41  33.52  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19306  Mast rad urban type                               A  18.13  12.16NA  13.47NA  12.16    13.47     3.86  34.15  35.46  34.15  35.46  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19307  Mast mod rad                                      A  18.23  12.07NA  13.27NA  12.07    13.27     3.86  34.16  35.36  34.16  35.36  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19316  Suspension of breast                              A  11.09   9.50NA  10.21NA   9.50    10.21     2.19  22.78  23.49  22.78  23.49  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19318  Reduction of large breast                         A  16.03  13.87NA  14.90NA  13.87    14.90     3.15  33.05  34.08  33.05  34.08  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19324  Enlarge breast                                    A   6.80   5.86NA   6.17NA   5.86     6.17     1.45  14.11  14.42  14.11  14.42  0090.10.71.1921000             25.5217 090 99      0.00   0.00   0.00
19325  Enlarge breast with implant                       A   8.64   8.75NA   9.45NA   8.75     9.45     1.68  19.07  19.77  19.07  19.77  0090.10.71.1921000             25.5217 090 99      0.00   0.00   0.00
19328  Removal of breast implant                         A   6.48   6.79NA   7.34NA   6.79     7.34     1.28  14.55  15.10  14.55  15.10  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19330  Removal of implant material                       A   8.54   8.38NA   9.09NA   8.38     9.09     1.66  18.58  19.29  18.58  19.29  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19340  Immediate breast prosthesis                       A  13.99   8.97NA  14.10NA   8.97    14.10     2.74  25.70  30.83  25.70  30.83  0090.10.71.1921110             25.5217 090 99      0.00   0.00   0.00
19342  Delayed breast prosthesis                         A  12.63  12.25NA  13.28NA  12.25    13.28     2.43  27.31  28.34  27.31  28.34  0090.10.71.1921010             25.5217 090 99      0.00   0.00   0.00
19350  Breast reconstruction                             A   9.11  13.60    13.85     9.06     9.72     1.78  24.49  24.74  19.95  20.61  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19355  Correct inverted nipple(s)                        A   8.52  10.14    10.13     6.24     6.52     1.82  20.48  20.47  16.58  16.86  0090.10.71.1921000             25.5217 090 99      0.00   0.00   0.00
19357  Breast reconstruction                             A  18.50  21.54NA  23.79NA  21.54    23.79     3.61  43.65  45.90  43.65  45.90  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19361  Breast reconstr w/lat flap                        A  23.36  22.01NA  24.43NA  22.01    24.43     4.59  49.96  52.38  49.96  52.38  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19364  Breast reconstruction                             A  42.58  31.69NA  34.56NA  31.69    34.56     8.23  82.50  85.37  82.50  85.37  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19366  Breast reconstruction                             A  21.84  14.41NA  15.73NA  14.41    15.73     4.45  40.70  42.02  40.70  42.02  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19367  Breast reconstruction                             A  26.80  21.48NA  23.29NA  21.48    23.29     5.26  53.54  55.35  53.54  55.35  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19368  Breast reconstruction                             A  33.90  25.63NA  28.12NA  25.63    28.12     6.65  66.18  68.67  66.18  68.67  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19369  Breast reconstruction                             A  31.31  23.66NA  26.25NA  23.66    26.25     6.14  61.11  63.70  61.11  63.70  0090.10.71.1921210             25.5217 090 99      0.00   0.00   0.00
19370  Surgery of breast capsule                         A   9.17   9.27NA  10.04NA   9.27    10.04     1.79  20.23  21.00  20.23  21.00  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19371  Removal of breast capsule                         A  10.62  10.51NA  11.38NA  10.51    11.38     2.06  23.19  24.06  23.19  24.06  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19380  Revise breast reconstruction                      A  10.41  10.37NA  11.22NA  10.37    11.22     2.02  22.80  23.65  22.80  23.65  0090.10.71.1921100             25.5217 090 99      0.00   0.00   0.00
19396  Design custom breast implant                      A   2.17   4.44     5.14     1.40     1.59     0.45   7.06   7.76   4.02   4.21  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
19499  Breast surgery procedure                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
2000F  Blood pressure measure                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20005  I&d abscess subfascial                            A   3.58   4.54     4.64     2.62     2.66     0.58   8.70   8.80   6.78   6.82  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
2001F  Weight record                                     I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2002F  Clin sign vol ovrld assess                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2004F  Initial exam involved joints                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2010F  Vital signs recorded                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20100  Explore wound neck                                A  10.38   5.15NA   5.76NA   5.15     5.76     1.96  17.49  18.10  17.49  18.10  0010.10.80.1021200             25.5217 090 99      0.00   0.00   0.00
20101  Explore wound chest                               A   3.23   7.74     7.91     1.98     2.04     0.69  11.66  11.83   5.90   5.96  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20102  Explore wound abdomen                             A   3.98   8.97     9.29     2.58     2.80     0.80  13.75  14.07   7.36   7.58  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20103  Explore wound extremity                           A   5.34  10.21    10.62     3.93     4.15     0.99  16.54  16.95  10.26  10.48  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
2014F  Mental status assess                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20150  Excise epiphyseal bar                             A  14.75  11.30NA  12.58NA  11.30    12.58     2.92  28.97  30.25  28.97  30.25  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
2018F  Hydration status assess                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2019F  Dilated macul exam done                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2020F  Dilated fundus eval done                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20200  Muscle biopsy                                     A   1.46   3.96     4.12     0.97     1.03     0.33   5.75   5.91   2.76   2.82  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
20205  Deep muscle biopsy                                A   2.35   5.00     5.28     1.55     1.68     0.56   7.91   8.19   4.46   4.59  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
20206  Needle biopsy muscle                              A   0.99   6.21     5.66     0.69     0.63     0.10   7.30   6.75   1.78   1.72  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
2021F  Dilat macul+ exam done                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2022F  Dil retina exam interp rev                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20220  Bone biopsy trocar/needle                         A   1.27   3.42     2.95     0.82     0.74     0.11   4.80   4.33   2.20   2.12  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
20225  Bone biopsy trocar/needle                         A   1.87  15.89    13.33     1.25     1.14     0.23  17.99  15.43   3.35   3.24  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
2024F  7 field photo interp doc rev                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20240  Bone biopsy excisional                            A   3.28   2.77NA   2.85NA   2.77     2.85     0.52   6.57   6.65   6.57   6.65  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20245  Bone biopsy excisional                            A   8.95   7.87NA   8.34NA   7.87     8.34     1.64  18.46  18.93  18.46  18.93  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20250  Open bone biopsy                                  A   5.19   4.69NA   4.98NA   4.69     4.98     1.22  11.10  11.39  11.10  11.39  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20251  Open bone biopsy                                  A   5.72   5.10NA   5.28NA   5.10     5.28     1.32  12.14  12.32  12.14  12.32  0010.10.80.1020200             25.5217 090 99      0.00   0.00   0.00
2026F  Eye image valid to dx rev                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2027F  Optic nerve head eval done                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2028F  Foot exam performed                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2029F  Complete phys skin exam done                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2030F  H2o stat docd normal                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2031F  H2o stat docd dehydrated                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2035F  Tymp memb motion examd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2040F  Bk pn xm on init visit date                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2044F  Doc mntl tst b/4 bk trxmnt                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
2050F  Wound char size etc docd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20500  Injection of sinus tract                          A   1.28   1.80     1.67     1.20     1.10     0.12   3.20   3.07   2.60   2.50  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20501  Inject sinus tract for x-ray                      A   0.76   2.80     2.53     0.32     0.28     0.07   3.63   3.36   1.15   1.11  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
20520  Removal of foreign body                           A   1.90   3.45     3.62     1.99     2.10     0.30   5.65   5.82   4.19   4.30  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20525  Removal of foreign body                           A   3.54   9.50     9.68     3.07     3.25     0.64  13.68  13.86   7.25   7.43  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20526  Ther injection carp tunnel                        A   0.94   1.10     1.13     0.59     0.63     0.14   2.18   2.21   1.67   1.71  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
20550  Inj tendon sheath/ligament                        A   0.75   0.83     0.85     0.37     0.40     0.08   1.66   1.68   1.20   1.23  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
20551  Inj tendon origin/insertion                       A   0.75   0.85     0.91     0.41     0.45     0.08   1.68   1.74   1.24   1.28  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
20552  Inj trigger point 1/2 muscl                       A   0.66   0.81     0.86     0.35     0.40     0.07   1.54   1.59   1.08   1.13  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
20553  Inject trigger points =/> 3                       A   0.75   0.93     1.00     0.39     0.45     0.07   1.75   1.82   1.21   1.27  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
20555  Place ndl musc/tis for rt                         A   6.00   2.85NA   2.83NA   2.85     2.83     0.86   9.71   9.69   9.71   9.69  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
2060F  Pt talk eval hlthwkr re mdd                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20600  Drain/inject joint/bursa                          A   0.66   0.84     0.86     0.41     0.42     0.07   1.57   1.59   1.14   1.15  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
20605  Drain/inject joint/bursa                          A   0.68   0.94     0.98     0.44     0.46     0.08   1.70   1.74   1.20   1.22  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
20610  Drain/inject joint/bursa                          A   0.79   1.36     1.43     0.55     0.58     0.12   2.27   2.34   1.46   1.49  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
20612  Aspirate/inj ganglion cyst                        A   0.70   0.91     0.97     0.44     0.46     0.08   1.69   1.75   1.22   1.24  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
20615  Treatment of bone cyst                            A   2.33   3.69     3.78     2.00     2.08     0.29   6.31   6.40   4.62   4.70  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20650  Insert and remove bone pin                        A   2.28   3.15     3.31     1.89     1.96     0.29   5.72   5.88   4.46   4.53  0010.10.80.1020110             25.5217 090 99      0.00   0.00   0.00
20660  Apply rem fixation device                         A   4.00   2.10NA   2.22NA   2.10     2.22     1.10   7.20   7.32   7.20   7.32  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
20661  Application of head brace                         A   5.26   7.36NA   7.77NA   7.36     7.77     1.64  14.26  14.67  14.26  14.67  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
20662  Application of pelvis brace                       A   6.38   5.62NA   4.74NA   5.62     4.74     0.61  12.61  11.73  12.61  11.73  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
20663  Application of thigh brace                        A   5.74   6.46NA   6.98NA   6.46     6.98     1.14  13.34  13.86  13.34  13.86  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
20664  Application of halo                               A  10.06  10.16NA  10.63NA  10.16    10.63     3.60  23.82  24.29  23.82  24.29  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
20665  Removal of fixation device                        A   1.36   1.75     1.57     1.25     1.17     0.11   3.22   3.04   2.72   2.64  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
20670  Removal of support implant                        A   1.79   9.16     8.81     2.24     2.30     0.30  11.25  10.90   4.33   4.39  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
20680  Removal of support implant                        A   5.96  10.67    11.16     5.36     5.75     1.06  17.69  18.18  12.38  12.77  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
20690  Apply bone fixation device                        A   8.78   6.41NA   7.27NA   6.41     7.27     1.62  16.81  17.67  16.81  17.67  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
20692  Apply bone fixation device                        A  16.27  12.53NA  14.38NA  12.53    14.38     2.80  31.60  33.45  31.60  33.45  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20693  Adjust bone fixation device                       A   6.06   6.17NA   6.39NA   6.17     6.39     1.07  13.30  13.52  13.30  13.52  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
20694  Remove bone fixation device                       A   4.28   7.26     7.41     4.78     5.01     0.76  12.30  12.45   9.82  10.05  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
20696  Comp multiplane ext fixation                      A  17.56  12.69NA  15.51NA  12.69    15.51     1.25  31.50  34.32  31.50  34.32  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20697  Comp ext fixate strut change                      A   0.00  49.48    58.00    49.48NA  58.00 NA  0.01  49.49  58.01  49.49  58.01  0000.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
20802  Replantation arm complete                         A  42.62  22.13NA  23.11NA  22.13    23.11     3.04  67.79  68.77  67.79  68.77  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
20805  Replant forearm complete                          A  51.46  22.27NA  18.05NA  22.27    18.05    10.12  83.85  79.63  83.85  79.63  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
20808  Replantation hand complete                        A  63.09  47.23NA  50.32NA  47.23    50.32    12.40 122.72 125.81 122.72 125.81  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
20816  Replantation digit complete                       A  31.95  27.23NA  26.94NA  27.23    26.94     3.98  63.16  62.87  63.16  62.87  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20822  Replantation digit complete                       A  26.66  23.89NA  24.09NA  23.89    24.09     5.26  55.81  56.01  55.81  56.01  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20824  Replantation thumb complete                       A  31.95  25.62NA  24.13NA  25.62    24.13     6.27  63.84  62.35  63.84  62.35  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
20827  Replantation thumb complete                       A  27.48  25.07NA  24.69NA  25.07    24.69     5.40  57.95  57.57  57.95  57.57  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
20838  Replantation foot complete                        A  42.88  23.67NA  23.52NA  23.67    23.52     3.06  69.61  69.46  69.61  69.46  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
20900  Removal of bone for graft                         A   3.00   8.50     8.62     3.25     2.77     0.56  12.06  12.18   6.81   6.33  0000.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
20902  Removal of bone for graft                         A   4.58   4.17NA   3.75NA   4.17     3.75     0.87   9.62   9.20   9.62   9.20  0000.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
20910  Remove cartilage for graft                        A   5.53   6.16NA   6.31NA   6.16     6.31     0.71  12.40  12.55  12.40  12.55  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
20912  Remove cartilage for graft                        A   6.54   6.83NA   7.25NA   6.83     7.25     0.99  14.36  14.78  14.36  14.78  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
20920  Removal of fascia for graft                       A   5.51   5.61NA   5.89NA   5.61     5.89     0.69  11.81  12.09  11.81  12.09  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
20922  Removal of fascia for graft                       A   6.93   9.28     9.01     6.28     6.22     1.28  17.49  17.22  14.49  14.43  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20924  Removal of tendon for graft                       A   6.68   6.88NA   7.21NA   6.88     7.21     1.20  14.76  15.09  14.76  15.09  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20926  Removal of tissue for graft                       A   5.79   5.82NA   5.98NA   5.82     5.98     1.17  12.78  12.94  12.78  12.94  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
20930  Sp bone algrft morsel add-on                      B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20931  Sp bone algrft struct add-on                      A   1.81   0.99NA   1.03NA   0.99     1.03     0.56   3.36   3.40   3.36   3.40  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
20936  Sp bone agrft local add-on                        B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
20937  Sp bone agrft morsel add-on                       A   2.79   1.57NA   1.62NA   1.57     1.62     0.68   5.04   5.09   5.04   5.09  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
20938  Sp bone agrft struct add-on                       A   3.02   1.68NA   1.74NA   1.68     1.74     0.83   5.53   5.59   5.53   5.59  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
20950  Fluid pressure muscle                             A   1.26   5.68     5.61     1.16     1.22     0.23   7.17   7.10   2.65   2.71  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
20955  Fibula bone graft microvasc                       A  40.26  28.58NA  30.96NA  28.58    30.96     6.65  75.49  77.87  75.49  77.87  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20956  Iliac bone graft microvasc                        A  41.18  28.73NA  30.65NA  28.73    30.65     8.11  78.02  79.94  78.02  79.94  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20957  Mt bone graft microvasc                           A  42.61  24.93NA  28.63NA  24.93    28.63     8.39  75.93  79.63  75.93  79.63  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20962  Other bone graft microvasc                        A  39.21  30.44NA  33.18NA  30.44    33.18     7.71  77.36  80.10  77.36  80.10  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20969  Bone/skin graft microvasc                         A  45.43  31.18NA  33.82NA  31.18    33.82     6.65  83.26  85.90  83.26  85.90  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20970  Bone/skin graft iliac crest                       A  44.58  29.98NA  31.43NA  29.98    31.43     8.79  83.35  84.80  83.35  84.80  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20972  Bone/skin graft metatarsal                        A  44.51  19.73NA  17.74NA  19.73    17.74     3.42  67.66  65.67  67.66  65.67  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
20973  Bone/skin graft great toe                         A  47.27  28.49NA  34.61NA  28.49    34.61     3.37  79.13  85.25  79.13  85.25  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
20974  Electrical bone stimulation                       A   0.62   1.29     1.43     0.68     0.72     0.12   2.03   2.17   1.42   1.46  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
20975  Electrical bone stimulation                       A   2.60   2.01NA   2.09NA   2.01     2.09     0.58   5.19   5.27   5.19   5.27  0000.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
20979  Us bone stimulation                               A   0.62   0.82     0.84     0.29     0.29     0.08   1.52   1.54   0.99   0.99  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
20982  Ablate bone tumor(s) perq                         A   7.27  97.51    88.94     3.31     3.06     0.80 105.58  97.01  11.38  11.13  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
20985  Cptr-asst dir ms px                               A   2.50   1.40NA   1.50NA   1.40     1.50     0.49   4.39   4.49   4.39   4.49  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
20999  Musculoskeletal surgery                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
21010  Incision of jaw joint                             A  11.04   8.81NA   9.56NA   8.81     9.56     1.41  21.26  22.01  21.26  22.01  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
21011  Exc face les sc < 2 cm                            A   2.99   6.26     6.26     3.95     3.95     0.45   9.70   9.70   7.39   7.39  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21012  Exc face les sbq 2+ cm                            A   4.45   5.04NA   5.04NA   5.04     5.04     0.72  10.21  10.21  10.21  10.21  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21013  Exc face tum deep < 2 cm                          A   5.42   8.74     8.74     5.65     5.65     0.81  14.97  14.97  11.88  11.88  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21014  Exc face tum deep 2+ cm                           A   7.13   7.46NA   7.46NA   7.46     7.46     1.15  15.74  15.74  15.74  15.74  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21015  Resect face tum < 2 cm                            A   9.89   7.59NA   9.50NA   7.59     9.50     1.86  19.34  21.25  19.34  21.25  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21016  Resect face tum + cm                              A  15.26  13.07NA  13.07NA  13.07    13.07     2.91  31.24  31.24  31.24  31.24  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21025  Excision of bone lower jaw                        A  10.03  14.42    15.17    10.50    11.30     1.44  25.89  26.64  21.97  22.77  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21026  Excision of facial bone(s)                        A   5.70  11.13    11.75     7.93     8.41     0.83  17.66  18.28  14.46  14.94  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21029  Contour of face bone lesion                       A   8.39  12.48    13.21     8.92     9.56     1.64  22.51  23.24  18.95  19.59  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21030  Excise max/zygoma b9 tumor                        A   4.91   9.14     9.71     6.39     6.87     0.76  14.81  15.38  12.06  12.54  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21031  Remove exostosis mandible                         A   3.30   7.44     7.80     4.72     5.06     0.41  11.15  11.51   8.43   8.77  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21032  Remove exostosis maxilla                          A   3.34   7.59     7.96     4.59     4.94     0.42  11.35  11.72   8.35   8.70  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21034  Excise max/zygoma mlg tumor                       A  17.38  19.31    20.61    14.81    16.06     2.43  39.12  40.42  34.62  35.87  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21040  Excise mandible lesion                            A   4.91   9.26     9.84     6.40     6.95     0.75  14.92  15.50  12.06  12.61  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21044  Removal of jaw bone lesion                        A  12.80  11.48NA  12.37NA  11.48    12.37     1.78  26.06  26.95  26.06  26.95  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21045  Extensive jaw surgery                             A  18.37  15.41NA  16.73NA  15.41    16.73     2.51  36.29  37.61  36.29  37.61  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21046  Remove mandible cyst complex                      A  14.21  16.03NA  17.41NA  16.03    17.41     1.82  32.06  33.44  32.06  33.44  0090.10.69.2120010             25.5217 090 99      0.00   0.00   0.00
21047  Excise lwr jaw cyst w/repair                      A  20.07  15.66NA  17.23NA  15.66    17.23     2.58  38.31  39.88  38.31  39.88  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21048  Remove maxilla cyst complex                       A  14.71  16.18NA  17.81NA  16.18    17.81     1.89  32.78  34.41  32.78  34.41  0090.10.69.2120010             25.5217 090 99      0.00   0.00   0.00
21049  Excis uppr jaw cyst w/repair                      A  19.32  14.98NA  15.84NA  14.98    15.84     2.46  36.76  37.62  36.76  37.62  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21050  Removal of jaw joint                              A  11.76  11.80NA  12.47NA  11.80    12.47     2.30  25.86  26.53  25.86  26.53  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
21060  Remove jaw joint cartilage                        A  11.07  10.69NA  11.70NA  10.69    11.70     2.34  24.10  25.11  24.10  25.11  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
21070  Remove coronoid process                           A   8.62   8.67NA   9.13NA   8.67     9.13     1.10  18.39  18.85  18.39  18.85  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
21073  Mnpj of tmj w/anesth                              A   3.45   7.15     7.65     3.29     3.70     0.68  11.28  11.78   7.42   7.83  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
21076  Prepare face/oral prosthesis                      A  13.40  13.32    15.05     9.15    10.49     1.70  28.42  30.15  24.25  25.59  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
21077  Prepare face/oral prosthesis                      A  33.70  32.77    37.54    23.45    26.53     4.32  70.79  75.56  61.47  64.55  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
21079  Prepare face/oral prosthesis                      A  22.31  22.91    25.78    15.55    17.72     2.87  48.09  50.96  40.73  42.90  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21080  Prepare face/oral prosthesis                      A  25.06  26.00    29.04    17.28    19.63     3.22  54.28  57.32  45.56  47.91  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21081  Prepare face/oral prosthesis                      A  22.85  24.03    26.89    15.79    17.87     2.95  49.83  52.69  41.59  43.67  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21082  Prepare face/oral prosthesis                      A  20.84  23.23    26.31    15.30    17.57     2.66  46.73  49.81  38.80  41.07  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21083  Prepare face/oral prosthesis                      A  19.27  22.76    25.66    14.24    16.40     1.37  43.40  46.30  34.88  37.04  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21084  Prepare face/oral prosthesis                      A  22.48  25.82    28.80    16.52    18.79     2.89  51.19  54.17  41.89  44.16  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21085  Prepare face/oral prosthesis                      A   8.99  10.86    12.65     6.38     7.23     3.34  23.19  24.98  18.71  19.56  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
21086  Prepare face/oral prosthesis                      A  24.88  23.92    28.05    16.89    19.38     3.19  51.99  56.12  44.96  47.45  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
21087  Prepare face/oral prosthesis                      A  24.88  23.82    27.83    16.73    19.03     3.19  51.89  55.90  44.80  47.10  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21088  Prepare face/oral prosthesis                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.10.69.2100000             25.5217 090 99      0.00   0.00   0.00
21089  Prepare face/oral prosthesis                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
21100  Maxillofacial fixation                            A   4.73  13.68    11.85     5.47     4.71     0.64  19.05  17.22  10.84  10.08  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21110  Interdental fixation                              A   5.99  15.79    16.72    12.29    13.08     0.76  22.54  23.47  19.04  19.83  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21116  Injection jaw joint x-ray                         A   0.81   3.42     3.33     0.35     0.38     0.05   4.28   4.19   1.21   1.24  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
21120  Reconstruction of chin                            A   5.10  12.58    13.03     8.97     9.48     1.00  18.68  19.13  15.07  15.58  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
21121  Reconstruction of chin                            A   7.81  14.11    15.07    10.49    11.23     0.54  22.46  23.42  18.84  19.58  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21122  Reconstruction of chin                            A   8.71  11.17NA  11.79NA  11.17    11.79     0.61  20.49  21.11  20.49  21.11  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21123  Reconstruction of chin                            A  11.34  13.47NA  15.56NA  13.47    15.56     0.80  25.61  27.70  25.61  27.70  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21125  Augmentation lower jaw bone                       A  10.80  76.24    74.31    10.33    11.48     2.13  89.17  87.24  23.26  24.41  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21127  Augmentation lower jaw bone                       A  12.44  94.88    96.47    11.88    13.23     1.59 108.91 110.50  25.91  27.26  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21137  Reduction of forehead                             A  10.24   8.91NA   9.26NA   8.91     9.26     2.00  21.15  21.50  21.15  21.50  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21138  Reduction of forehead                             A  12.87  11.43NA  12.35NA  11.43    12.35     1.82  26.12  27.04  26.12  27.04  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21139  Reduction of forehead                             A  15.02  12.93NA  14.19NA  12.93    14.19     1.06  29.01  30.27  29.01  30.27  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21141  Reconstruct midface lefort                        A  19.57  17.08NA  18.24NA  17.08    18.24     3.84  40.49  41.65  40.49  41.65  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21142  Reconstruct midface lefort                        A  20.28  16.55NA  18.59NA  16.55    18.59     3.99  40.82  42.86  40.82  42.86  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21143  Reconstruct midface lefort                        A  21.05  17.73NA  19.75NA  17.73    19.75     4.48  43.26  45.28  43.26  45.28  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21145  Reconstruct midface lefort                        A  23.94  18.35NA  20.42NA  18.35    20.42     1.68  43.97  46.04  43.97  46.04  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21146  Reconstruct midface lefort                        A  24.87  20.73NA  23.22NA  20.73    23.22     4.89  50.49  52.98  50.49  52.98  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21147  Reconstruct midface lefort                        A  26.47  19.86NA  21.01NA  19.86    21.01     1.87  48.20  49.35  48.20  49.35  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21150  Reconstruct midface lefort                        A  25.96  20.50NA  22.77NA  20.50    22.77     1.83  48.29  50.56  48.29  50.56  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21151  Reconstruct midface lefort                        A  29.02  25.08NA  24.56NA  25.08    24.56     3.73  57.83  57.31  57.83  57.31  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21154  Reconstruct midface lefort                        A  31.29  27.36NA  31.32NA  27.36    31.32     4.01  62.66  66.62  62.66  66.62  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21155  Reconstruct midface lefort                        A  35.22  26.13NA  28.65NA  26.13    28.65     2.50  63.85  66.37  63.85  66.37  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21159  Reconstruct midface lefort                        A  43.14  33.83NA  39.89NA  33.83    39.89     5.51  82.48  88.54  82.48  88.54  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21160  Reconstruct midface lefort                        A  47.19  28.59NA  28.85NA  28.59    28.85     3.35  79.13  79.39  79.13  79.39  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21172  Reconstruct orbit/forehead                        A  28.20  20.84NA  23.96NA  20.84    23.96     3.61  52.65  55.77  52.65  55.77  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21175  Reconstruct orbit/forehead                        A  33.56  25.18NA  28.82NA  25.18    28.82    12.00  70.74  74.38  70.74  74.38  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21179  Reconstruct entire forehead                       A  22.65  17.92NA  20.18NA  17.92    20.18     4.45  45.02  47.28  45.02  47.28  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21180  Reconstruct entire forehead                       A  25.58  20.14NA  22.40NA  20.14    22.40     3.29  49.01  51.27  49.01  51.27  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21181  Contour cranial bone lesion                       A  10.28   9.39NA  10.58NA   9.39    10.58     1.30  20.97  22.16  20.97  22.16  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21182  Reconstruct cranial bone                          A  32.58  21.85NA  22.72NA  21.85    22.72     4.17  58.60  59.47  58.60  59.47  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21183  Reconstruct cranial bone                          A  35.70  23.92NA  24.56NA  23.92    24.56     7.01  66.63  67.27  66.63  67.27  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21184  Reconstruct cranial bone                          A  38.62  27.12NA  30.61NA  27.12    30.61     7.60  73.34  76.83  73.34  76.83  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21188  Reconstruction of midface                         A  23.15  21.42NA  22.24NA  21.42    22.24     2.97  47.54  48.36  47.54  48.36  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21193  Reconst lwr jaw w/o graft                         A  18.90  15.76NA  17.94NA  15.76    17.94     4.03  38.69  40.87  38.69  40.87  0090.10.69.2122210             25.5217 090 99      0.00   0.00   0.00
21194  Reconst lwr jaw w/graft                           A  21.82  16.59NA  17.60NA  16.59    17.60     2.80  41.21  42.22  41.21  42.22  0090.10.69.2122200             25.5217 090 99      0.00   0.00   0.00
21195  Reconst lwr jaw w/o fixation                      A  19.16  18.03NA  19.43NA  18.03    19.43     2.44  39.63  41.03  39.63  41.03  0090.10.69.2122200             25.5217 090 99      0.00   0.00   0.00
21196  Reconst lwr jaw w/fixation                        A  20.83  19.87NA  21.81NA  19.87    21.81     2.66  43.36  45.30  43.36  45.30  0090.10.69.2122210             25.5217 090 99      0.00   0.00   0.00
21198  Reconstr lwr jaw segment                          A  15.71  16.37NA  17.62NA  16.37    17.62     2.17  34.25  35.50  34.25  35.50  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21199  Reconstr lwr jaw w/advance                        A  16.73  11.30NA  12.33NA  11.30    12.33     2.15  30.18  31.21  30.18  31.21  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21206  Reconstruct upper jaw bone                        A  15.59  17.19NA  19.51NA  17.19    19.51     3.08  35.86  38.18  35.86  38.18  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21208  Augmentation of facial bones                      A  11.42  39.37    41.16    11.10    11.50     2.24  53.03  54.82  24.76  25.16  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21209  Reduction of facial bones                         A   7.82  15.17    15.72    10.07    10.70     1.53  24.52  25.07  19.42  20.05  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21210  Face bone graft                                   A  11.69  50.23    53.00    11.54    12.87     1.51  63.43  66.20  24.74  26.07  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21215  Lower jaw bone graft                              A  12.23  96.04   101.33    11.79    13.13     2.39 110.66 115.95  26.41  27.75  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
21230  Rib cartilage graft                               A  11.17   9.58NA  10.25NA   9.58    10.25     2.19  22.94  23.61  22.94  23.61  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21235  Ear cartilage graft                               A   7.50  12.87    13.33     8.30     8.79     1.10  21.47  21.93  16.90  17.39  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21240  Reconstruction of jaw joint                       A  16.07  14.24NA  15.62NA  14.24    15.62     2.04  32.35  33.73  32.35  33.73  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
21242  Reconstruction of jaw joint                       A  14.59  13.21NA  14.26NA  13.21    14.26     1.87  29.67  30.72  29.67  30.72  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
21243  Reconstruction of jaw joint                       A  24.53  21.16NA  23.27NA  21.16    23.27     3.15  48.84  50.95  48.84  50.95  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
21244  Reconstruction of lower jaw                       A  13.62  15.69NA  16.81NA  15.69    16.81     1.93  31.24  32.36  31.24  32.36  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21245  Reconstruction of jaw                             A  13.12  18.42    19.10    11.93    12.55     1.67  33.21  33.89  26.72  27.34  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21246  Reconstruction of jaw                             A  12.92  10.11NA  10.80NA  10.11    10.80     1.64  24.67  25.36  24.67  25.36  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21247  Reconstruct lower jaw bone                        A  24.37  18.85NA  19.78NA  18.85    19.78     4.81  48.03  48.96  48.03  48.96  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21248  Reconstruction of jaw                             A  12.74  17.23    18.63    11.61    12.91     1.63  31.60  33.00  25.98  27.28  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21249  Reconstruction of jaw                             A  18.77  22.30    24.40    15.67    17.91     2.39  43.46  45.56  36.83  39.07  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21255  Reconstruct lower jaw bone                        A  18.46  19.88NA  19.82NA  19.88    19.82     2.35  40.69  40.63  40.69  40.63  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21256  Reconstruction of orbit                           A  17.66  14.97NA  16.57NA  14.97    16.57     2.25  34.88  36.48  34.88  36.48  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21260  Revise eye sockets                                A  17.90  19.95NA  21.79NA  19.95    21.79     1.26  39.11  40.95  39.11  40.95  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21261  Revise eye sockets                                A  34.07  24.31NA  23.67NA  24.31    23.67     6.71  65.09  64.45  65.09  64.45  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21263  Revise eye sockets                                A  31.01  22.38NA  22.32NA  22.38    22.32     2.20  55.59  55.53  55.59  55.53  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21267  Revise eye sockets                                A  20.69  22.54NA  24.13NA  22.54    24.13     4.07  47.30  48.89  47.30  48.89  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21268  Revise eye sockets                                A  27.07  21.74NA  20.59NA  21.74    20.59     5.32  54.13  52.98  54.13  52.98  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21270  Augmentation cheek bone                           A  10.63  15.69    17.28     9.30    10.62     1.51  27.83  29.42  21.44  22.76  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21275  Revision orbitofacial bones                       A  11.76  10.62NA  11.84NA  10.62    11.84     2.30  24.68  25.90  24.68  25.90  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21280  Revision of eyelid                                A   7.13   8.04NA   8.90NA   8.04     8.90     1.40  16.57  17.43  16.57  17.43  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
21282  Revision of eyelid                                A   4.27   5.85NA   6.36NA   5.85     6.36     0.77  10.89  11.40  10.89  11.40  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
21295  Revision of jaw muscle/bone                       A   1.90   2.92NA   2.90NA   2.92     2.90     0.37   5.19   5.17   5.19   5.17  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21296  Revision of jaw muscle/bone                       A   4.78   6.39NA   5.93NA   6.39     5.93     0.61  11.78  11.32  11.78  11.32  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21299  Cranio/maxillofacial surgery                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
21310  Treatment of nose fracture                        A   0.58   2.60     2.74     0.16     0.16     0.10   3.28   3.42   0.84   0.84  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
21315  Treatment of nose fracture                        A   1.83   5.80     6.04     2.33     2.45     0.29   7.92   8.16   4.45   4.57  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
21320  Treatment of nose fracture                        A   1.88   5.32     5.52     1.89     2.00     0.27   7.47   7.67   4.04   4.15  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
21325  Treatment of nose fracture                        A   4.18   9.06NA   9.16NA   9.06     9.16     0.67  13.91  14.01  13.91  14.01  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21330  Treatment of nose fracture                        A   5.79  10.27NA  10.54NA  10.27    10.54     0.73  16.79  17.06  16.79  17.06  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21335  Treatment of nose fracture                        A   9.02  11.40NA  11.88NA  11.40    11.88     1.22  21.64  22.12  21.64  22.12  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21336  Treat nasal septal fracture                       A   6.77  11.44NA  11.93NA  11.44    11.93     0.91  19.12  19.61  19.12  19.61  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21337  Treat nasal septal fracture                       A   3.39   7.81     8.12     4.71     5.01     0.52  11.72  12.03   8.62   8.92  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21338  Treat nasoethmoid fracture                        A   6.87  13.80NA  14.27NA  13.80    14.27     1.36  22.03  22.50  22.03  22.50  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21339  Treat nasoethmoid fracture                        A   8.50  13.57NA  13.43NA  13.57    13.43     1.66  23.73  23.59  23.73  23.59  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21340  Treatment of nose fracture                        A  11.49   9.98NA  10.16NA   9.98    10.16     1.48  22.95  23.13  22.95  23.13  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21343  Treatment of sinus fracture                       A  14.32  16.85NA  17.14NA  16.85    17.14     2.82  33.99  34.28  33.99  34.28  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21344  Treatment of sinus fracture                       A  21.57  19.96NA  22.09NA  19.96    22.09     7.73  49.26  51.39  49.26  51.39  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
21345  Treat nose/jaw fracture                           A   9.06  12.87    13.11     8.57     8.77     1.17  23.10  23.34  18.80  19.00  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21346  Treat nose/jaw fracture                           A  11.45  14.53NA  14.83NA  14.53    14.83     1.48  27.46  27.76  27.46  27.76  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
21347  Treat nose/jaw fracture                           A  13.53  17.29NA  18.47NA  17.29    18.47     1.71  32.53  33.71  32.53  33.71  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21348  Treat nose/jaw fracture                           A  17.52  14.45NA  16.57NA  14.45    16.57     2.24  34.21  36.33  34.21  36.33  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
21355  Treat cheek bone fracture                         A   4.45   8.04     8.48     4.73     5.16     0.56  13.05  13.49   9.74  10.17  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
21356  Treat cheek bone fracture                         A   4.83   8.96     9.31     5.53     5.85     0.71  14.50  14.85  11.07  11.39  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
21360  Treat cheek bone fracture                         A   7.19   7.54NA   8.15NA   7.54     8.15     0.91  15.64  16.25  15.64  16.25  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21365  Treat cheek bone fracture                         A  16.77  13.40NA  14.67NA  13.40    14.67     2.80  32.97  34.24  32.97  34.24  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21366  Treat cheek bone fracture                         A  18.60  15.13NA  17.36NA  15.13    17.36     3.67  37.40  39.63  37.40  39.63  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
21385  Treat eye socket fracture                         A   9.57   9.79NA  10.20NA   9.79    10.20     1.22  20.58  20.99  20.58  20.99  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21386  Treat eye socket fracture                         A   9.57   8.19NA   8.49NA   8.19     8.49     1.87  19.63  19.93  19.63  19.93  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21387  Treat eye socket fracture                         A  10.11  10.03NA  10.50NA  10.03    10.50     1.97  22.11  22.58  22.11  22.58  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21390  Treat eye socket fracture                         A  11.23  10.25NA  11.31NA  10.25    11.31     1.89  23.37  24.43  23.37  24.43  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21395  Treat eye socket fracture                         A  14.70  12.13NA  13.74NA  12.13    13.74     1.87  28.70  30.31  28.70  30.31  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21400  Treat eye socket fracture                         A   1.50   3.61     3.80     2.63     2.79     0.27   5.38   5.57   4.40   4.56  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21401  Treat eye socket fracture                         A   3.68   9.52     9.57     4.43     4.62     0.72  13.92  13.97   8.83   9.02  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21406  Treat eye socket fracture                         A   7.42   7.82NA   8.73NA   7.82     8.73     0.95  16.19  17.10  16.19  17.10  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21407  Treat eye socket fracture                         A   9.02   8.51NA   9.22NA   8.51     9.22     1.59  19.12  19.83  19.12  19.83  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21408  Treat eye socket fracture                         A  12.78  11.34NA  12.60NA  11.34    12.60     2.51  26.63  27.89  26.63  27.89  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
21421  Treat mouth roof fracture                         A   6.02  14.72    15.28    11.48    11.98     1.18  21.92  22.48  18.68  19.18  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21422  Treat mouth roof fracture                         A   8.73   9.67NA  10.30NA   9.67    10.30     1.13  19.53  20.16  19.53  20.16  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21423  Treat mouth roof fracture                         A  10.85  11.25NA  12.40NA  11.25    12.40     2.13  24.23  25.38  24.23  25.38  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
21431  Treat craniofacial fracture                       A   7.90  12.41NA  12.54NA  12.41    12.54     1.55  21.86  21.99  21.86  21.99  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21432  Treat craniofacial fracture                       A   8.82  10.16NA  11.34NA  10.16    11.34     1.71  20.69  21.87  20.69  21.87  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21433  Treat craniofacial fracture                       A  26.29  18.40NA  18.97NA  18.40    18.97     5.17  49.86  50.43  49.86  50.43  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21435  Treat craniofacial fracture                       A  20.26  15.61NA  16.23NA  15.61    16.23     2.59  38.46  39.08  38.46  39.08  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21436  Treat craniofacial fracture                       A  30.30  24.32NA  27.36NA  24.32    27.36     5.96  60.58  63.62  60.58  63.62  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
21440  Treat dental ridge fracture                       A   3.44  12.09    12.58     9.25     9.59     0.67  16.20  16.69  13.36  13.70  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21445  Treat dental ridge fracture                       A   6.26  15.05    15.57    11.07    11.53     0.80  22.11  22.63  18.13  18.59  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21450  Treat lower jaw fracture                          A   3.71  12.63    13.28     9.59     9.94     0.65  16.99  17.64  13.95  14.30  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21451  Treat lower jaw fracture                          A   5.65  15.66    16.64    12.08    12.74     0.72  22.03  23.01  18.45  19.11  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21452  Treat lower jaw fracture                          A   2.40  14.19    13.41     7.11     7.23     0.48  17.07  16.29   9.99  10.11  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21453  Treat lower jaw fracture                          A   6.64  18.03    19.17    14.77    15.51     1.05  25.72  26.86  22.46  23.20  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21454  Treat lower jaw fracture                          A   7.36   8.06NA   8.76NA   8.06     8.76     0.92  16.34  17.04  16.34  17.04  0090.10.69.2120010             25.5217 090 99      0.00   0.00   0.00
21461  Treat lower jaw fracture                          A   9.31  48.72    51.81    16.70    17.56     1.40  59.43  62.52  27.41  28.27  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
21462  Treat lower jaw fracture                          A  11.01  50.61    53.30    17.63    18.76     1.41  63.03  65.72  30.05  31.18  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21465  Treat lower jaw fracture                          A  13.12  12.31NA  13.76NA  12.31    13.76     2.58  28.01  29.46  28.01  29.46  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21470  Treat lower jaw fracture                          A  17.54  15.15NA  16.70NA  15.15    16.70     2.89  35.58  37.13  35.58  37.13  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21480  Reset dislocated jaw                              A   0.61   1.97     2.02     0.24     0.26     0.10   2.68   2.73   0.95   0.97  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
21485  Reset dislocated jaw                              A   4.77  14.42    15.28    11.32    11.96     0.61  19.80  20.66  16.70  17.34  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
21490  Repair dislocated jaw                             A  12.95  11.97NA  12.89NA  11.97    12.89     2.55  27.47  28.39  27.47  28.39  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
21495  Treat hyoid bone fracture                         A   6.79  13.04NA  13.84NA  13.04    13.84     0.86  20.69  21.49  20.69  21.49  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21497  Interdental wiring                                A   4.64  14.31    14.72    11.37    11.71     0.90  19.85  20.26  16.91  17.25  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21499  Head surgery procedure                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
21501  Drain neck/chest lesion                           A   3.98   8.31     8.63     4.67     4.88     0.75  13.04  13.36   9.40   9.61  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21502  Drain chest lesion                                A   7.55   5.87NA   5.73NA   5.87     5.73     1.60  15.02  14.88  15.02  14.88  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21510  Drainage of bone lesion                           A   6.20   6.18NA   6.35NA   6.18     6.35     1.45  13.83  14.00  13.83  14.00  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21550  Biopsy of neck/chest                              A   2.11   5.11     5.21     2.24     2.30     0.30   7.52   7.62   4.65   4.71  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
21552  Exc neck les sc 3+ cm                             A   6.49   5.64NA   5.64NA   5.64     5.64     1.28  13.41  13.41  13.41  13.41  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21554  Exc neck tum deep 5+ cm                           A  11.13   8.79NA   8.79NA   8.79     8.79     2.08  22.00  22.00  22.00  22.00  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21555  Exc neck les sc < 3 cm                            A   3.96   7.25     7.45     4.29     4.38     0.77  11.98  12.18   9.02   9.11  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21556  Exc neck tum deep < 5 cm                          A   7.66   6.05NA   6.93NA   6.05     6.93     1.44  15.15  16.03  15.15  16.03  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21557  Resect neck tum < 5 cm                            A  14.75   8.73NA  11.40NA   8.73    11.40     2.78  26.26  28.93  26.26  28.93  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21558  Resect neck tum 5+ cm                             A  21.58  15.25NA  15.25NA  15.25    15.25     4.07  40.90  40.90  40.90  40.90  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21600  Partial removal of rib                            A   7.26   7.70NA   8.12NA   7.70     8.12     1.56  16.52  16.94  16.52  16.94  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21610  Partial removal of rib                            A  15.91  12.49NA  14.07NA  12.49    14.07     5.70  34.10  35.68  34.10  35.68  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21615  Removal of rib                                    A  10.45   6.67NA   6.52NA   6.67     6.52     2.46  19.58  19.43  19.58  19.43  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
21616  Removal of rib and nerves                         A  12.69   8.19NA   6.95NA   8.19     6.95     3.03  23.91  22.67  23.91  22.67  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
21620  Partial removal of sternum                        A   7.28   6.58NA   6.74NA   6.58     6.74     1.62  15.48  15.64  15.48  15.64  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21627  Sternal debridement                               A   7.30   7.27NA   7.36NA   7.27     7.36     1.64  16.21  16.30  16.21  16.30  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21630  Extensive sternum surgery                         A  19.18  14.29NA  14.91NA  14.29    14.91     4.03  37.50  38.12  37.50  38.12  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21632  Extensive sternum surgery                         A  19.68  12.70NA  12.86NA  12.70    12.86     4.93  37.31  37.47  37.31  37.47  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21685  Hyoid myotomy & suspension                        A  15.26  12.49NA  13.55NA  12.49    13.55     1.96  29.71  30.77  29.71  30.77  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
21700  Revision of neck muscle                           A   6.31   4.88NA   4.71NA   4.88     4.71     1.49  12.68  12.51  12.68  12.51  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21705  Revision of neck muscle/rib                       A   9.92   5.69NA   4.73NA   5.69     4.73     2.34  17.95  16.99  17.95  16.99  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21720  Revision of neck muscle                           A   5.80   5.33NA   5.87NA   5.33     5.87     2.06  13.19  13.73  13.19  13.73  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21725  Revision of neck muscle                           A   7.19   7.02NA   7.45NA   7.02     7.45     1.41  15.62  16.05  15.62  16.05  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21740  Reconstruction of sternum                         A  17.57   9.80NA   9.36NA   9.80     9.36     3.46  30.83  30.39  30.83  30.39  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21742  Repair stern/nuss w/o scope                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21743  Repair sternum/nuss w/scope                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21750  Repair of sternum separation                      A  11.40   6.86NA   6.68NA   6.86     6.68     2.70  20.96  20.78  20.96  20.78  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21800  Treatment of rib fracture                         A   1.01   1.78     1.91     1.85     2.00     0.18   2.97   3.10   3.04   3.19  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21805  Treatment of rib fracture                         A   2.88   4.15NA   4.22NA   4.15     4.22     0.67   7.70   7.77   7.70   7.77  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
21810  Treatment of rib fracture(s)                      A   7.03   6.65NA   7.26NA   6.65     7.26     1.63  15.31  15.92  15.31  15.92  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21820  Treat sternum fracture                            A   1.36   2.33     2.50     2.40     2.59     0.26   3.95   4.12   4.02   4.21  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21825  Treat sternum fracture                            A   7.76   7.10NA   7.13NA   7.10     7.13     1.82  16.68  16.71  16.68  16.71  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
21899  Neck/chest surgery procedure                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
21920  Biopsy soft tissue of back                        A   2.11   5.08     5.14     2.30     2.42     0.34   7.53   7.59   4.75   4.87  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
21925  Biopsy soft tissue of back                        A   4.63   6.97     7.37     4.50     4.84     0.92  12.52  12.92  10.05  10.39  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21930  Exc back les sc < 3 cm                            A   4.94   7.56     7.79     4.68     4.78     1.02  13.52  13.75  10.64  10.74  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
21931  Exc back les sc 3+ cm                             A   6.88   5.70NA   5.70NA   5.70     5.70     1.41  13.99  13.99  13.99  13.99  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21932  Exc back tum deep < 5 cm                          A   9.82   8.08NA   8.08NA   8.08     8.08     2.08  19.98  19.98  19.98  19.98  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21933  Exc back tum deep 5+ cm                           A  11.13   8.53NA   8.53NA   8.53     8.53     2.35  22.01  22.01  22.01  22.01  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
21935  Resect back tum < 5 cm                            A  15.72  11.41NA  11.71NA  11.41    11.71     3.20  30.33  30.63  30.33  30.63  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
21936  Resect back tum 5+ cm                             A  22.55  15.50NA  15.50NA  15.50    15.50     4.59  42.64  42.64  42.64  42.64  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22010  I&d p-spine c/t/cerv-thor                         A  12.75  11.36NA  12.01NA  11.36    12.01     3.29  27.40  28.05  27.40  28.05  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
22015  I&d p-spine l/s/ls                                A  12.64  11.25NA  11.79NA  11.25    11.79     3.07  26.96  27.50  26.96  27.50  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
22100  Remove part of neck vertebra                      A  11.00  10.61NA  11.33NA  10.61    11.33     3.95  25.56  26.28  25.56  26.28  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22101  Remove part thorax vertebra                       A  11.08   9.98NA  10.06NA   9.98    10.06     3.97  25.03  25.11  25.03  25.11  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22102  Remove part lumbar vertebra                       A  11.08  10.30NA  10.76NA  10.30    10.76     2.66  24.04  24.50  24.04  24.50  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22103  Remove extra spine segment                        A   2.34   1.32NA   1.36NA   1.32     1.36     0.64   4.30   4.34   4.30   4.34  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
22110  Remove part of neck vertebra                      A  14.00  12.41NA  13.10NA  12.41    13.10     5.02  31.43  32.12  31.43  32.12  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22112  Remove part thorax vertebra                       A  14.07  11.88NA  12.93NA  11.88    12.93     5.04  30.99  32.04  30.99  32.04  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22114  Remove part lumbar vertebra                       A  14.07  12.16NA  12.80NA  12.16    12.80     2.77  29.00  29.64  29.00  29.64  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22116  Remove extra spine segment                        A   2.32   1.27NA   1.33NA   1.27     1.33     0.60   4.19   4.25   4.19   4.25  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
22206  Cut spine 3 col thor                              A  37.18  24.70NA  26.43NA  24.70    26.43     7.31  69.19  70.92  69.19  70.92  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22207  Cut spine 3 col lumb                              A  36.68  24.44NA  26.12NA  24.44    26.12     9.18  70.30  71.98  70.30  71.98  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22208  Cut spine 3 col addl seg                          A   9.66   5.27NA   5.63NA   5.27     5.63     2.58  17.51  17.87  17.51  17.87  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
22210  Revision of neck spine                            A  25.38  19.73NA  20.74NA  19.73    20.74     6.74  51.85  52.86  51.85  52.86  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22212  Revision of thorax spine                          A  20.99  17.03NA  18.01NA  17.03    18.01     4.96  42.98  43.96  42.98  43.96  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
22214  Revision of lumbar spine                          A  21.02  17.13NA  17.97NA  17.13    17.97     5.11  43.26  44.10  43.26  44.10  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22216  Revise extra spine segment                        A   6.03   3.39NA   3.51NA   3.39     3.51     1.51  10.93  11.05  10.93  11.05  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
22220  Revision of neck spine                            A  22.94  17.84NA  19.04NA  17.84    19.04     6.41  47.19  48.39  47.19  48.39  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22222  Revision of thorax spine                          A  23.09  16.16NA  19.34NA  16.16    19.34     4.54  43.79  46.97  43.79  46.97  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
22224  Revision of lumbar spine                          A  23.09  17.79NA  18.88NA  17.79    18.88     5.36  46.24  47.33  46.24  47.33  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22226  Revise extra spine segment                        A   6.03   3.35NA   3.48NA   3.35     3.48     1.58  10.96  11.09  10.96  11.09  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
22305  Treat spine process fracture                      A   2.13   2.89     3.07     2.44     2.60     0.41   5.43   5.61   4.98   5.14  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
22310  Treat spine fracture                              A   3.89   4.03     4.37     3.41     3.72     0.77   8.69   9.03   8.07   8.38  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
22315  Treat spine fracture                              A  10.11  12.81    13.56     9.83    10.46     2.54  25.46  26.21  22.48  23.11  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
22318  Treat odontoid fx w/o graft                       A  22.72  17.43NA  18.27NA  17.43    18.27     7.66  47.81  48.65  47.81  48.65  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22319  Treat odontoid fx w/graft                         A  25.33  18.84NA  20.11NA  18.84    20.11     9.09  53.26  54.53  53.26  54.53  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22325  Treat spine fracture                              A  19.87  16.24NA  17.16NA  16.24    17.16     5.68  41.79  42.71  41.79  42.71  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22326  Treat neck spine fracture                         A  20.84  16.29NA  17.16NA  16.29    17.16     6.29  43.42  44.29  43.42  44.29  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22327  Treat thorax spine fracture                       A  20.77  16.74NA  17.89NA  16.74    17.89     5.61  43.12  44.27  43.12  44.27  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22328  Treat each add spine fx                           A   4.60   2.52NA   2.62NA   2.52     2.62     1.36   8.48   8.58   8.48   8.58  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
22505  Manipulation of spine                             A   1.87   1.31NA   1.43NA   1.31     1.43     0.29   3.47   3.59   3.47   3.59  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
22520  Percut vertebroplasty thor                        A   9.22  55.57    53.30     5.15     4.80     1.06  65.85  63.58  15.43  15.08  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
22521  Percut vertebroplasty lumb                        A   8.65  54.94    53.07     4.93     4.60     1.00  64.59  62.72  14.58  14.25  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
22522  Percut vertebroplasty addl                        A   4.30   1.97NA   1.89NA   1.97     1.89     0.54   6.81   6.73   6.81   6.73  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
22523  Percut kyphoplasty thor                           A   9.26   6.22NA   6.13NA   6.22     6.13     1.82  17.30  17.21  17.30  17.21  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
22524  Percut kyphoplasty lumbar                         A   8.86   6.04NA   5.97NA   6.04     5.97     1.74  16.64  16.57  16.64  16.57  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
22525  Percut kyphoplasty add-on                         A   4.47   2.35NA   2.33NA   2.35     2.33     0.95   7.77   7.75   7.77   7.75  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
22526  Idet single level                                 N+  6.10  55.12    59.00     2.93     3.49     0.54  61.76  65.64   9.57  10.13  9010.10.80.1099999             25.5217 090 99      0.00   0.00   0.00
22527  Idet 1 or more levels                             N+  3.03  46.41    50.65     1.02     1.33     0.24  49.68  53.92   4.29   4.60  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
22532  Lat thorax spine fusion                           A  25.99  18.82NA  19.90NA  18.82    19.90     7.55  52.36  53.44  52.36  53.44  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22533  Lat lumbar spine fusion                           A  24.79  18.19NA  19.23NA  18.19    19.23     6.37  49.35  50.39  49.35  50.39  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22534  Lat thor/lumb addl seg                            A   5.99   3.31NA   3.43NA   3.31     3.43     1.59  10.89  11.01  10.89  11.01  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22548  Neck spine fusion                                 A  27.06  20.34NA  21.81NA  20.34    21.81     9.70  57.10  58.57  57.10  58.57  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22551  Neck spine fuse&remove addl                       A  25.00  18.65NA  18.65NA  18.65    18.65     7.55  51.20  51.20  51.20  51.20  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22552  Addl neck spine fusion                            A   6.50   3.65NA   3.65NA   3.65     3.65     1.78  11.93  11.93  11.93  11.93  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22554  Neck spine fusion                                 A  17.69  14.28NA  14.70NA  14.28    14.70     5.46  37.43  37.85  37.43  37.85  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22556  Thorax spine fusion                               A  24.70  17.77NA  18.63NA  17.77    18.63     6.61  49.08  49.94  49.08  49.94  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22558  Lumbar spine fusion                               A  23.53  16.19NA  17.15NA  16.19    17.15     5.65  45.37  46.33  45.37  46.33  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22585  Additional spinal fusion                          A   5.52   3.00NA   3.10NA   3.00     3.10     1.59  10.11  10.21  10.11  10.21  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22590  Spine & skull spinal fusion                       A  21.76  17.38NA  18.25NA  17.38    18.25     7.03  46.17  47.04  46.17  47.04  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22595  Neck spinal fusion                                A  20.64  16.69NA  17.55NA  16.69    17.55     6.56  43.89  44.75  43.89  44.75  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22600  Neck spine fusion                                 A  17.40  14.77NA  15.53NA  14.77    15.53     5.31  37.48  38.24  37.48  38.24  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22610  Thorax spine fusion                               A  17.28  14.59NA  15.34NA  14.59    15.34     4.85  36.72  37.47  36.72  37.47  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22612  Lumbar spine fusion                               A  23.53  17.22NA  18.04NA  17.22    18.04     6.22  46.97  47.79  46.97  47.79  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22614  Spine fusion extra segment                        A   6.43   3.57NA   3.69NA   3.57     3.69     1.77  11.77  11.89  11.77  11.89  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22630  Lumbar spine fusion                               A  22.09  16.91NA  17.67NA  16.91    17.67     6.26  45.26  46.02  45.26  46.02  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22632  Spine fusion extra segment                        A   5.22   2.88NA   2.99NA   2.88     2.99     1.49   9.59   9.70   9.59   9.70  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22800  Fusion of spine                                   A  19.50  15.37NA  16.06NA  15.37    16.06     4.89  39.76  40.45  39.76  40.45  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22802  Fusion of spine                                   A  32.11  22.65NA  23.65NA  22.65    23.65     7.50  62.26  63.26  62.26  63.26  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22804  Fusion of spine                                   A  37.50  25.73NA  26.91NA  25.73    26.91     8.51  71.74  72.92  71.74  72.92  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22808  Fusion of spine                                   A  27.51  19.34NA  20.21NA  19.34    20.21     7.25  54.10  54.97  54.10  54.97  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22810  Fusion of spine                                   A  31.50  20.78NA  21.71NA  20.78    21.71     7.92  60.20  61.13  60.20  61.13  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22812  Fusion of spine                                   A  34.25  24.09NA  25.84NA  24.09    25.84     6.74  65.08  66.83  65.08  66.83  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22818  Kyphectomy 1-2 segments                           A  34.33  23.27NA  24.84NA  23.27    24.84     6.75  64.35  65.92  64.35  65.92  0090.11.76.1320222             25.5217 090 99      0.00   0.00   0.00
22819  Kyphectomy 3 or more                              A  39.38  26.88NA  28.70NA  26.88    28.70    14.12  80.38  82.20  80.38  82.20  0090.11.76.1320222             25.5217 090 99      0.00   0.00   0.00
22830  Exploration of spinal fusion                      A  11.22   9.58NA   9.99NA   9.58     9.99     2.89  23.69  24.10  23.69  24.10  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22840  Insert spine fixation device                      A  12.52   6.94NA   7.16NA   6.94     7.16     3.48  22.94  23.16  22.94  23.16  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
22841  Insert spine fixation device                      B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
22842  Insert spine fixation device                      A  12.56   6.98NA   7.21NA   6.98     7.21     3.44  22.98  23.21  22.98  23.21  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22843  Insert spine fixation device                      A  13.44   7.46NA   7.77NA   7.46     7.77     3.49  24.39  24.70  24.39  24.70  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22844  Insert spine fixation device                      A  16.42   9.35NA   9.62NA   9.35     9.62     3.68  29.45  29.72  29.45  29.72  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22845  Insert spine fixation device                      A  11.94   6.53NA   6.76NA   6.53     6.76     3.65  22.12  22.35  22.12  22.35  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22846  Insert spine fixation device                      A  12.40   6.79NA   7.02NA   6.79     7.02     3.76  22.95  23.18  22.95  23.18  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22847  Insert spine fixation device                      A  13.78   7.51NA   7.71NA   7.51     7.71     4.94  26.23  26.43  26.23  26.43  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22848  Insert pelv fixation device                       A   5.99   3.41NA   3.52NA   3.41     3.52     1.39  10.79  10.90  10.79  10.90  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22849  Reinsert spinal fixation                          A  19.17  14.05NA  14.65NA  14.05    14.65     5.13  38.35  38.95  38.35  38.95  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22850  Remove spine fixation device                      A   9.82   8.61NA   8.99NA   8.61     8.99     2.61  21.04  21.42  21.04  21.42  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22851  Apply spine prosth device                         A   6.70   3.68NA   3.82NA   3.68     3.82     1.89  12.27  12.41  12.27  12.41  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
22852  Remove spine fixation device                      A   9.37   8.34NA   8.72NA   8.34     8.72     2.40  20.11  20.49  20.11  20.49  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22855  Remove spine fixation device                      A  15.86  12.24NA  12.79NA  12.24    12.79     4.74  32.84  33.39  32.84  33.39  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22856  Cerv artific diskectomy                           A  24.05  17.47NA  18.16NA  17.47    18.16     7.27  48.79  49.48  48.79  49.48  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22857  Lumbar artif diskectomy                           R  27.13  16.54NA  16.18NA  16.54    16.18     5.77  49.44  49.08  49.44  49.08  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22861  Revise cerv artific disc                          A  33.36  17.05NA  17.43NA  17.05    17.43     9.10  59.51  59.89  59.51  59.89  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22862  Revise lumbar artif disc                          R  32.63  17.24NA  17.61NA  17.24    17.61     6.41  56.28  56.65  56.28  56.65  0090.10.71.1920222             25.5217 090 99      0.00   0.00   0.00
22864  Remove cerv artif disc                            A  29.40  18.45NA  21.76NA  18.45    21.76     8.03  55.88  59.19  55.88  59.19  0090.10.69.2120220             25.5217 090 99      0.00   0.00   0.00
22865  Remove lumb artif disc                            R  31.75  21.76NA  21.16NA  21.76    21.16     6.23  59.74  59.14  59.74  59.14  0090.10.71.1920222             25.5217 090 99      0.00   0.00   0.00
22899  Spine surgery procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
22900  Exc back tum deep < 5 cm                          A   8.32   5.49NA   6.61NA   5.49     6.61     1.71  15.52  16.64  15.52  16.64  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22901  Exc back tum deep 5+ cm                           A  10.11   7.39NA   7.39NA   7.39     7.39     2.09  19.59  19.59  19.59  19.59  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22902  Exc abd les sc < 3 cm                             A   4.42   7.75     7.75     4.95     4.95     0.71  12.88  12.88  10.08  10.08  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22903  Exc abd les sc > 3 cm                             A   6.39   5.57NA   5.57NA   5.57     5.57     1.21  13.17  13.17  13.17  13.17  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
22904  Resect abd tum < 5 cm                             A  16.69  10.40NA  10.40NA  10.40    10.40     3.54  30.63  30.63  30.63  30.63  0090.09.81.1020211             25.5217 090 99      0.00   0.00   0.00
22905  Resect abd tum > 5 cm                             A  21.58  13.67NA  13.67NA  13.67    13.67     4.59  39.84  39.84  39.84  39.84  0090.09.81.1020211             25.5217 090 99      0.00   0.00   0.00
22999  Abdomen surgery procedure                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
23000  Removal of calcium deposits                       A   4.48  10.67    11.36     5.25     5.58     0.86  16.01  16.70  10.59  10.92  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
23020  Release shoulder joint                            A   9.36   8.87NA   9.25NA   8.87     9.25     1.79  20.02  20.40  20.02  20.40  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
23030  Drain shoulder lesion                             A   3.47   8.30     8.59     3.31     3.47     0.68  12.45  12.74   7.46   7.62  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
23031  Drain shoulder bursa                              A   2.79   8.27     8.70     2.93     3.12     0.53  11.59  12.02   6.25   6.44  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
23035  Drain shoulder bone lesion                        A   9.16   8.92NA   9.21NA   8.92     9.21     1.79  19.87  20.16  19.87  20.16  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
23040  Exploratory shoulder surgery                      A   9.75   9.29NA   9.74NA   9.29     9.74     1.90  20.94  21.39  20.94  21.39  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23044  Exploratory shoulder surgery                      A   7.59   7.52NA   7.82NA   7.52     7.82     1.49  16.60  16.90  16.60  16.90  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
23065  Biopsy shoulder tissues                           A   2.30   3.59     3.71     2.24     2.36     0.38   6.27   6.39   4.92   5.04  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
23066  Biopsy shoulder tissues                           A   4.30   9.98    10.50     4.87     5.15     0.84  15.12  15.64  10.01  10.29  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23071  Exc shoulder les sc > 3 cm                        A   5.91   5.36NA   5.36NA   5.36     5.36     1.21  12.48  12.48  12.48  12.48  0090.10.80.1021200             25.5217 090 99      0.00   0.00   0.00
23073  Exc shoulder tum deep > 5 cm                      A  10.13   8.51NA   8.51NA   8.51     8.51     2.04  20.68  20.68  20.68  20.68  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
23075  Exc shoulder les sc < 3 cm                        A   4.21   6.53     8.49     3.37     4.53     0.86  11.60  13.56   8.44   9.60  0090.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
23076  Exc shoulder tum deep < 5 cm                      A   7.41   6.85NA   7.02NA   6.85     7.02     1.51  15.77  15.94  15.77  15.94  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23077  Resect shoulder tum < 5 cm                        A  17.66  12.71NA  13.15NA  12.71    13.15     3.59  33.96  34.40  33.96  34.40  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23078  Resect shoulder tum > 5 cm                        A  22.55  14.10NA  14.10NA  14.10    14.10     4.81  41.46  41.46  41.46  41.46  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23100  Biopsy of shoulder joint                          A   6.20   6.94NA   7.37NA   6.94     7.37     1.22  14.36  14.79  14.36  14.79  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23101  Shoulder joint surgery                            A   5.72   6.19NA   6.45NA   6.19     6.45     1.13  13.04  13.30  13.04  13.30  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
23105  Remove shoulder joint lining                      A   8.48   8.39NA   8.77NA   8.39     8.77     1.66  18.53  18.91  18.53  18.91  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23106  Incision of collarbone joint                      A   6.13   6.80NA   7.33NA   6.80     7.33     1.21  14.14  14.67  14.14  14.67  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
23107  Explore treat shoulder joint                      A   8.87   8.62NA   9.02NA   8.62     9.02     1.71  19.20  19.60  19.20  19.60  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23120  Partial removal collar bone                       A   7.39   8.02NA   8.45NA   8.02     8.45     1.45  16.86  17.29  16.86  17.29  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
23125  Removal of collar bone                            A   9.64   9.02NA   9.57NA   9.02     9.57     1.89  20.55  21.10  20.55  21.10  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23130  Remove shoulder bone part                         A   7.77   8.35NA   8.76NA   8.35     8.76     1.52  17.64  18.05  17.64  18.05  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
23140  Removal of bone lesion                            A   7.12   6.58NA   7.01NA   6.58     7.01     1.41  15.11  15.54  15.11  15.54  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23145  Removal of bone lesion                            A   9.40   8.95NA   9.43NA   8.95     9.43     1.85  20.20  20.68  20.20  20.68  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23146  Removal of bone lesion                            A   8.08   8.10NA   8.75NA   8.10     8.75     1.59  17.77  18.42  17.77  18.42  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
23150  Removal of humerus lesion                         A   8.91   8.49NA   8.91NA   8.49     8.91     1.71  19.11  19.53  19.11  19.53  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23155  Removal of humerus lesion                         A  10.86  10.08NA  10.63NA  10.08    10.63     2.13  23.07  23.62  23.07  23.62  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23156  Removal of humerus lesion                         A   9.11   8.77NA   9.25NA   8.77     9.25     1.79  19.67  20.15  19.67  20.15  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
23170  Remove collar bone lesion                         A   7.21   7.24NA   7.97NA   7.24     7.97     1.41  15.86  16.59  15.86  16.59  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23172  Remove shoulder blade lesion                      A   7.31   7.46NA   8.03NA   7.46     8.03     1.45  16.22  16.79  16.22  16.79  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
23174  Remove humerus lesion                             A  10.05   9.99NA  10.51NA   9.99    10.51     1.97  22.01  22.53  22.01  22.53  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23180  Remove collar bone lesion                         A   8.99   8.98NA   9.13NA   8.98     9.13     1.81  19.78  19.93  19.78  19.93  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
23182  Remove shoulder blade lesion                      A   8.61   9.02NA   9.39NA   9.02     9.39     1.68  19.31  19.68  19.31  19.68  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
23184  Remove humerus lesion                             A   9.90   9.72NA   9.99NA   9.72     9.99     1.90  21.52  21.79  21.52  21.79  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23190  Partial removal of scapula                        A   7.47   7.49NA   8.02NA   7.49     8.02     1.48  16.44  16.97  16.44  16.97  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23195  Removal of head of humerus                        A  10.36   9.57NA  10.11NA   9.57    10.11     2.02  21.95  22.49  21.95  22.49  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23200  Resect clavicle tumor                             A  22.71  14.25NA  18.41NA  14.25    18.41     4.47  41.43  45.59  41.43  45.59  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23210  Resect scapula tumor                              A  27.21  15.92NA  21.11NA  15.92    21.11     5.35  48.48  53.67  48.48  53.67  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23220  Resect prox humerus tumor                         A  30.21  17.36NA  22.58NA  17.36    22.58     5.95  53.52  58.74  53.52  58.74  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23330  Remove shoulder foreign body                      A   1.90   4.38     4.54     2.10     2.18     0.35   6.63   6.79   4.35   4.43  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
23331  Remove shoulder foreign body                      A   7.63   8.02NA   8.40NA   8.02     8.40     1.49  17.14  17.52  17.14  17.52  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
23332  Remove shoulder foreign body                      A  12.37  11.01NA  11.52NA  11.01    11.52     2.39  25.77  26.28  25.77  26.28  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23350  Injection for shoulder x-ray                      A   1.00   3.27     2.98     0.43     0.40     0.10   4.37   4.08   1.53   1.50  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
23395  Muscle transfer shoulder/arm                      A  18.54  15.51NA  16.30NA  15.51    16.30     3.59  37.64  38.43  37.64  38.43  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
23397  Muscle transfers                                  A  16.76  13.48NA  14.16NA  13.48    14.16     3.30  33.54  34.22  33.54  34.22  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
23400  Fixation of shoulder blade                        A  13.87  11.87NA  12.43NA  11.87    12.43     2.73  28.47  29.03  28.47  29.03  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23405  Incision of tendon & muscle                       A   8.54   8.09NA   8.41NA   8.09     8.41     1.66  18.29  18.61  18.29  18.61  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
23406  Incise tendon(s) & muscle(s)                      A  11.01   9.62NA  10.02NA   9.62    10.02     2.16  22.79  23.19  22.79  23.19  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
23410  Repair rotator cuff acute                         A  11.39  10.46NA  10.86NA  10.46    10.86     2.21  24.06  24.46  24.06  24.46  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23412  Repair rotator cuff chronic                       A  11.93  10.80NA  11.18NA  10.80    11.18     2.31  25.04  25.42  25.04  25.42  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23415  Release of shoulder ligament                      A   9.23   9.21NA   9.64NA   9.21     9.64     1.81  20.25  20.68  20.25  20.68  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
23420  Repair of shoulder                                A  13.54  12.23NA  12.73NA  12.23    12.73     2.65  28.42  28.92  28.42  28.92  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23430  Repair biceps tendon                              A  10.17   9.51NA  10.07NA   9.51    10.07     1.97  21.65  22.21  21.65  22.21  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23440  Remove/transplant tendon                          A  10.64   9.39NA   9.79NA   9.39     9.79     2.06  22.09  22.49  22.09  22.49  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23450  Repair shoulder capsule                           A  13.70  11.37NA  11.92NA  11.37    11.92     2.70  27.77  28.32  27.77  28.32  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23455  Repair shoulder capsule                           A  14.67  11.98NA  12.52NA  11.98    12.52     2.85  29.50  30.04  29.50  30.04  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23460  Repair shoulder capsule                           A  15.82  13.10NA  13.71NA  13.10    13.71     3.12  32.04  32.65  32.04  32.65  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23462  Repair shoulder capsule                           A  15.72  12.66NA  13.32NA  12.66    13.32     3.11  31.49  32.15  31.49  32.15  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23465  Repair shoulder capsule                           A  16.30  13.27NA  13.92NA  13.27    13.92     3.20  32.77  33.42  32.77  33.42  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23466  Repair shoulder capsule                           A  15.80  13.82NA  14.51NA  13.82    14.51     3.11  32.73  33.42  32.73  33.42  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23470  Reconstruct shoulder joint                        A  17.89  14.18NA  14.81NA  14.18    14.81     3.50  35.57  36.20  35.57  36.20  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23472  Reconstruct shoulder joint                        A  22.65  17.01NA  17.83NA  17.01    17.83     4.41  44.07  44.89  44.07  44.89  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23480  Revision of collar bone                           A  11.54  10.18NA  10.71NA  10.18    10.71     2.25  23.97  24.50  23.97  24.50  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
23485  Revision of collar bone                           A  13.91  11.52NA  12.05NA  11.52    12.05     2.72  28.15  28.68  28.15  28.68  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23490  Reinforce clavicle                                A  12.16  10.97NA  12.13NA  10.97    12.13     2.39  25.52  26.68  25.52  26.68  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
23491  Reinforce shoulder bones                          A  14.54  12.30NA  12.89NA  12.30    12.89     2.87  29.71  30.30  29.71  30.30  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23500  Treat clavicle fracture                           A   2.21   3.49     3.67     3.52     3.77     0.41   6.11   6.29   6.14   6.39  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23505  Treat clavicle fracture                           A   3.83   5.38     5.67     4.85     5.14     0.72   9.93  10.22   9.40   9.69  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23515  Treat clavicle fracture                           A   9.69   9.40NA  10.10NA   9.40    10.10     1.89  20.98  21.68  20.98  21.68  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23520  Treat clavicle dislocation                        A   2.29   3.70     3.98     3.77     4.08     0.43   6.42   6.70   6.49   6.80  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
23525  Treat clavicle dislocation                        A   3.79   6.01     6.92     5.15     5.85     0.73  10.53  11.44   9.67  10.37  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
23530  Treat clavicle dislocation                        A   7.48   7.22NA   8.02NA   7.22     8.02     1.48  16.18  16.98  16.18  16.98  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
23532  Treat clavicle dislocation                        A   8.20   8.28NA   8.71NA   8.28     8.71     1.60  18.08  18.51  18.08  18.51  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
23540  Treat clavicle dislocation                        A   2.36   3.46     3.63     3.46     3.72     0.42   6.24   6.41   6.24   6.50  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23545  Treat clavicle dislocation                        A   3.43   5.10     5.42     4.33     4.60     0.60   9.13   9.45   8.36   8.63  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
23550  Treat clavicle dislocation                        A   7.59   7.55NA   7.88NA   7.55     7.88     1.47  16.61  16.94  16.61  16.94  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23552  Treat clavicle dislocation                        A   8.82   8.62NA   9.04NA   8.62     9.04     1.70  19.14  19.56  19.14  19.56  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23570  Treat shoulder blade fx                           A   2.36   3.71     3.91     3.85     4.10     0.43   6.50   6.70   6.64   6.89  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23575  Treat shoulder blade fx                           A   4.23   6.19     6.64     5.53     5.95     0.83  11.25  11.70  10.59  11.01  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
23585  Treat scapula fracture                            A  14.23  11.48NA  12.40NA  11.48    12.40     2.76  28.47  29.39  28.47  29.39  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23600  Treat humerus fracture                            A   3.11   5.42     5.68     4.79     5.11     0.60   9.13   9.39   8.50   8.82  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23605  Treat humerus fracture                            A   5.06   7.23     7.57     6.19     6.51     0.98  13.27  13.61  12.23  12.55  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23615  Treat humerus fracture                            A  12.30  11.07NA  11.71NA  11.07    11.71     2.39  25.76  26.40  25.76  26.40  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23616  Treat humerus fracture                            A  18.37  14.87NA  15.31NA  14.87    15.31     3.57  36.81  37.25  36.81  37.25  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
23620  Treat humerus fracture                            A   2.55   4.51     4.76     4.12     4.40     0.49   7.55   7.80   7.16   7.44  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23625  Treat humerus fracture                            A   4.10   5.92     6.22     5.23     5.50     0.77  10.79  11.09  10.10  10.37  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23630  Treat humerus fracture                            A  10.57   9.88NA  10.67NA   9.88    10.67     2.06  22.51  23.30  22.51  23.30  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23650  Treat shoulder dislocation                        A   3.53   4.35     4.58     3.67     3.93     0.61   8.49   8.72   7.81   8.07  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23655  Treat shoulder dislocation                        A   4.76   5.59NA   6.01NA   5.59     6.01     0.88  11.23  11.65  11.23  11.65  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23660  Treat shoulder dislocation                        A   7.66   7.75NA   8.16NA   7.75     8.16     1.49  16.90  17.31  16.90  17.31  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23665  Treat dislocation/fracture                        A   4.66   6.49     6.83     5.74     6.04     0.88  12.03  12.37  11.28  11.58  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23670  Treat dislocation/fracture                        A  12.28  10.57NA  11.45NA  10.57    11.45     2.39  25.24  26.12  25.24  26.12  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23675  Treat dislocation/fracture                        A   6.27   8.20     8.67     6.94     7.33     1.20  15.67  16.14  14.41  14.80  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
23680  Treat dislocation/fracture                        A  13.15  11.22NA  12.00NA  11.22    12.00     2.57  26.94  27.72  26.94  27.72  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23700  Fixation of shoulder                              A   2.57   2.58NA   2.70NA   2.58     2.70     0.49   5.64   5.76   5.64   5.76  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
23800  Fusion of shoulder joint                          A  14.73  12.41NA  13.06NA  12.41    13.06     2.92  30.06  30.71  30.06  30.71  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
23802  Fusion of shoulder joint                          A  18.42  15.14NA  16.40NA  15.14    16.40     3.61  37.17  38.43  37.17  38.43  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
23900  Amputation of arm & girdle                        A  20.72  15.02NA  16.89NA  15.02    16.89     4.09  39.83  41.70  39.83  41.70  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
23920  Amputation at shoulder joint                      A  16.23  12.92NA  14.33NA  12.92    14.33     3.19  32.34  33.75  32.34  33.75  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
23921  Amputation follow-up surgery                      A   5.72   5.75NA   6.97NA   5.75     6.97     1.36  12.83  14.05  12.83  14.05  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
23929  Shoulder surgery procedure                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
23930  Drainage of arm lesion                            A   2.99   6.62     6.69     2.71     2.83     0.61  10.22  10.29   6.31   6.43  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
23931  Drainage of arm bursa                             A   1.84   5.90     6.03     2.41     2.52     0.34   8.08   8.21   4.59   4.70  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
23935  Drain arm/elbow bone lesion                       A   6.38   6.97NA   7.43NA   6.97     7.43     1.24  14.59  15.05  14.59  15.05  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
24000  Exploratory elbow surgery                         A   6.08   6.55NA   6.91NA   6.55     6.91     1.17  13.80  14.16  13.80  14.16  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
24006  Release elbow joint                               A   9.74   9.16NA   9.66NA   9.16     9.66     1.82  20.72  21.22  20.72  21.22  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
24065  Biopsy arm/elbow soft tissue                      A   2.13   4.93     5.05     2.45     2.57     0.34   7.40   7.52   4.92   5.04  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
24066  Biopsy arm/elbow soft tissue                      A   5.35  10.91    11.45     5.35     5.74     1.07  17.33  17.87  11.77  12.16  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24071  Exc arm/elbow les sc 3+ cm                        A   5.70   5.31NA   5.31NA   5.31     5.31     1.15  12.16  12.16  12.16  12.16  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24073  Ex arm/elbow tum deep > 5 cm                      A  10.13   8.60NA   8.60NA   8.60     8.60     2.01  20.74  20.74  20.74  20.74  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24075  Exc arm/elbow les sc < 3 cm                       A   4.24   8.99     9.14     4.39     4.66     0.84  14.07  14.22   9.47   9.74  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24076  Ex arm/elbow tum deep < 5 cm                      A   7.41   6.50NA   7.17NA   6.50     7.17     1.48  15.39  16.06  15.39  16.06  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24077  Resect arm/elbow tum < 5 cm                       A  15.72  10.51NA  12.15NA  10.51    12.15     3.18  29.41  31.05  29.41  31.05  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
24079  Resect arm/elbow tum > 5 cm                       A  20.61  13.25NA  13.25NA  13.25    13.25     4.37  38.23  38.23  38.23  38.23  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24100  Biopsy elbow joint lining                         A   5.07   5.84NA   6.25NA   5.84     6.25     1.00  11.91  12.32  11.91  12.32  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24101  Explore/treat elbow joint                         A   6.30   6.97NA   7.31NA   6.97     7.31     1.21  14.48  14.82  14.48  14.82  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24102  Remove elbow joint lining                         A   8.26   8.04NA   8.48NA   8.04     8.48     1.55  17.85  18.29  17.85  18.29  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24105  Removal of elbow bursa                            A   3.78   5.44NA   5.76NA   5.44     5.76     0.72   9.94  10.26   9.94  10.26  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24110  Remove humerus lesion                             A   7.58   7.91NA   8.34NA   7.91     8.34     1.49  16.98  17.41  16.98  17.41  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
24115  Remove/graft bone lesion                          A  10.12   9.28NA   9.86NA   9.28     9.86     1.98  21.38  21.96  21.38  21.96  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24116  Remove/graft bone lesion                          A  12.23  10.55NA  11.12NA  10.55    11.12     2.40  25.18  25.75  25.18  25.75  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24120  Remove elbow lesion                               A   6.82   7.13NA   7.56NA   7.13     7.56     1.29  15.24  15.67  15.24  15.67  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
24125  Remove/graft bone lesion                          A   8.14   8.13NA   8.67NA   8.13     8.67     1.59  17.86  18.40  17.86  18.40  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24126  Remove/graft bone lesion                          A   8.62   8.50NA   8.96NA   8.50     8.96     1.68  18.80  19.26  18.80  19.26  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24130  Removal of head of radius                         A   6.42   7.05NA   7.39NA   7.05     7.39     1.20  14.67  15.01  14.67  15.01  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
24134  Removal of arm bone lesion                        A  10.22   9.64NA  10.03NA   9.64    10.03     2.00  21.86  22.25  21.86  22.25  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24136  Remove radius bone lesion                         A   8.40   7.79NA   8.69NA   7.79     8.69     1.64  17.83  18.73  17.83  18.73  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24138  Remove elbow bone lesion                          A   8.50   9.29NA   9.80NA   9.29     9.80     1.66  19.45  19.96  19.45  19.96  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24140  Partial removal of arm bone                       A   9.55   9.36NA   9.63NA   9.36     9.63     1.78  20.69  20.96  20.69  20.96  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24145  Partial removal of radius                         A   7.81   8.05NA   8.22NA   8.05     8.22     1.53  17.39  17.56  17.39  17.56  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
24147  Partial removal of elbow                          A   7.84   8.85NA   9.12NA   8.85     9.12     1.51  18.20  18.47  18.20  18.47  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
24149  Radical resection of elbow                        A  16.22  14.90NA  15.93NA  14.90    15.93     2.97  34.09  35.12  34.09  35.12  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24150  Resect distal humerus tumor                       A  23.46  15.03NA  18.75NA  15.03    18.75     4.62  43.11  46.83  43.11  46.83  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24152  Resect radius tumor                               A  19.99  12.76NA  16.67NA  12.76    16.67     3.92  36.67  40.58  36.67  40.58  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24155  Removal of elbow joint                            A  12.09  10.41NA  11.03NA  10.41    11.03     2.38  24.88  25.50  24.88  25.50  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24160  Remove elbow joint implant                        A   8.00   8.11NA   8.55NA   8.11     8.55     1.49  17.60  18.04  17.60  18.04  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
24164  Remove radius head implant                        A   6.43   6.73NA   7.05NA   6.73     7.05     1.26  14.42  14.74  14.42  14.74  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
24200  Removal of arm foreign body                       A   1.81   3.69     3.86     1.89     2.03     0.31   5.81   5.98   4.01   4.15  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
24201  Removal of arm foreign body                       A   4.70  10.34    10.54     4.98     5.21     0.92  15.96  16.16  10.60  10.83  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24220  Injection for elbow x-ray                         A   1.31   3.32     3.00     0.59     0.58     0.12   4.75   4.43   2.02   2.01  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
24300  Manipulate elbow w/anesth                         A   4.04   6.87NA   7.23NA   6.87     7.23     0.72  11.63  11.99  11.63  11.99  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24301  Muscle/tendon transfer                            A  10.38   9.51NA   9.94NA   9.51     9.94     2.02  21.91  22.34  21.91  22.34  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
24305  Arm tendon lengthening                            A   7.62   7.85NA   8.26NA   7.85     8.26     1.36  16.83  17.24  16.83  17.24  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
24310  Revision of arm tendon                            A   6.12   6.52NA   6.84NA   6.52     6.84     1.18  13.82  14.14  13.82  14.14  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
24320  Repair of arm tendon                              A  10.86   9.71NA  10.29NA   9.71    10.29     2.13  22.70  23.28  22.70  23.28  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
24330  Revision of arm muscles                           A   9.79   9.19NA   9.65NA   9.19     9.65     1.91  20.89  21.35  20.89  21.35  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24331  Revision of arm muscles                           A  10.95  10.37NA  11.25NA  10.37    11.25     2.16  23.48  24.36  23.48  24.36  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24332  Tenolysis triceps                                 A   7.91   8.25NA   8.69NA   8.25     8.69     1.55  17.71  18.15  17.71  18.15  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24340  Repair of biceps tendon                           A   8.08   8.17NA   8.56NA   8.17     8.56     1.58  17.83  18.22  17.83  18.22  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24341  Repair arm tendon/muscle                          A   9.49  10.17NA  10.82NA  10.17    10.82     1.85  21.51  22.16  21.51  22.16  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24342  Repair of ruptured tendon                         A  10.86   9.83NA  10.28NA   9.83    10.28     2.06  22.75  23.20  22.75  23.20  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24343  Repr elbow lat ligmnt w/tiss                      A   9.16   9.62NA  10.09NA   9.62    10.09     1.67  20.45  20.92  20.45  20.92  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24344  Reconstruct elbow lat ligmnt                      A  15.21  13.79NA  14.56NA  13.79    14.56     3.00  32.00  32.77  32.00  32.77  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24345  Repr elbw med ligmnt w/tissu                      A   9.16   9.49NA   9.99NA   9.49     9.99     1.67  20.32  20.82  20.32  20.82  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24346  Reconstruct elbow med ligmnt                      A  15.21  13.83NA  14.56NA  13.83    14.56     3.00  32.04  32.77  32.04  32.77  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24357  Repair elbow perc                                 A   5.44   6.42NA   6.71NA   6.42     6.71     1.03  12.89  13.18  12.89  13.18  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
24358  Repair elbow w/deb open                           A   6.66   7.27NA   7.65NA   7.27     7.65     1.25  15.18  15.56  15.18  15.56  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
24359  Repair elbow deb/attch open                       A   8.98   8.45NA   9.04NA   8.45     9.04     1.67  19.10  19.69  19.10  19.69  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
24360  Reconstruct elbow joint                           A  12.67  11.15NA  11.69NA  11.15    11.69     2.47  26.29  26.83  26.29  26.83  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24361  Reconstruct elbow joint                           A  14.41  12.29NA  12.84NA  12.29    12.84     2.84  29.54  30.09  29.54  30.09  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24362  Reconstruct elbow joint                           A  15.32  12.73NA  13.39NA  12.73    13.39     3.03  31.08  31.74  31.08  31.74  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24363  Replace elbow joint                               A  22.65  17.10NA  18.19NA  17.10    18.19     4.20  43.95  45.04  43.95  45.04  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24365  Reconstruct head of radius                        A   8.62   8.31NA   8.69NA   8.31     8.69     1.68  18.61  18.99  18.61  18.99  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24366  Reconstruct head of radius                        A   9.36   8.76NA   9.20NA   8.76     9.20     1.77  19.89  20.33  19.89  20.33  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24400  Revision of humerus                               A  11.33  10.41NA  10.88NA  10.41    10.88     2.19  23.93  24.40  23.93  24.40  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24410  Revision of humerus                               A  15.11  12.67NA  13.53NA  12.67    13.53     2.99  30.77  31.63  30.77  31.63  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24420  Revision of humerus                               A  13.73  12.50NA  13.13NA  12.50    13.13     2.70  28.93  29.56  28.93  29.56  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24430  Repair of humerus                                 A  15.25  12.71NA  13.52NA  12.71    13.52     2.95  30.91  31.72  30.91  31.72  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24435  Repair humerus with graft                         A  14.99  13.52NA  14.32NA  13.52    14.32     2.92  31.43  32.23  31.43  32.23  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24470  Revision of elbow joint                           A   8.93   8.24NA   9.25NA   8.24     9.25     1.77  18.94  19.95  18.94  19.95  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24495  Decompression of forearm                          A   8.41   8.98NA   9.07NA   8.98     9.07     1.79  19.18  19.27  19.18  19.27  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
24498  Reinforce humerus                                 A  12.28  10.71NA  11.20NA  10.71    11.20     2.40  25.39  25.88  25.39  25.88  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24500  Treat humerus fracture                            A   3.41   5.92     6.23     5.02     5.36     0.64   9.97  10.28   9.07   9.41  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24505  Treat humerus fracture                            A   5.39   7.81     8.18     6.54     6.88     1.05  14.25  14.62  12.98  13.32  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24515  Treat humerus fracture                            A  12.12  11.11NA  11.67NA  11.11    11.67     2.34  25.57  26.13  25.57  26.13  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24516  Treat humerus fracture                            A  12.19  10.63NA  11.12NA  10.63    11.12     2.38  25.20  25.69  25.20  25.69  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
24530  Treat humerus fracture                            A   3.69   6.30     6.63     5.31     5.65     0.69  10.68  11.01   9.69  10.03  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24535  Treat humerus fracture                            A   7.11   9.20     9.62     7.94     8.33     1.37  17.68  18.10  16.42  16.81  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24538  Treat humerus fracture                            A   9.77   9.96NA  10.39NA   9.96    10.39     1.91  21.64  22.07  21.64  22.07  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24545  Treat humerus fracture                            A  13.15  11.32NA  12.09NA  11.32    12.09     2.55  27.02  27.79  27.02  27.79  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24546  Treat humerus fracture                            A  14.91  12.77NA  13.33NA  12.77    13.33     2.89  30.57  31.13  30.57  31.13  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
24560  Treat humerus fracture                            A   2.98   5.41     5.68     4.46     4.78     0.56   8.95   9.22   8.00   8.32  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24565  Treat humerus fracture                            A   5.78   8.02     8.68     6.86     7.47     1.14  14.94  15.60  13.78  14.39  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24566  Treat humerus fracture                            A   9.06   9.85NA  10.39NA   9.85    10.39     1.79  20.70  21.24  20.70  21.24  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24575  Treat humerus fracture                            A   9.71   9.74NA  10.19NA   9.74    10.19     1.87  21.32  21.77  21.32  21.77  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24576  Treat humerus fracture                            A   3.06   5.85     6.18     4.90     5.24     0.58   9.49   9.82   8.54   8.88  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24577  Treat humerus fracture                            A   6.01   8.27     8.88     7.04     7.61     1.18  15.46  16.07  14.23  14.80  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24579  Treat humerus fracture                            A  11.44  10.68NA  11.25NA  10.68    11.25     2.20  24.32  24.89  24.32  24.89  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24582  Treat humerus fracture                            A  10.14  11.08NA  11.79NA  11.08    11.79     1.98  23.20  23.91  23.20  23.91  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24586  Treat elbow fracture                              A  15.78  13.08NA  13.70NA  13.08    13.70     3.04  31.90  32.52  31.90  32.52  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24587  Treat elbow fracture                              A  15.79  13.12NA  13.84NA  13.12    13.84     2.92  31.83  32.55  31.83  32.55  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24600  Treat elbow dislocation                           A   4.37   5.10     5.26     4.24     4.48     0.76  10.23  10.39   9.37   9.61  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24605  Treat elbow dislocation                           A   5.64   6.66NA   7.05NA   6.66     7.05     1.09  13.39  13.78  13.39  13.78  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24615  Treat elbow dislocation                           A   9.83   9.10NA   9.54NA   9.10     9.54     1.83  20.76  21.20  20.76  21.20  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24620  Treat elbow fracture                              A   7.22   7.42NA   7.79NA   7.42     7.79     1.36  16.00  16.37  16.00  16.37  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
24635  Treat elbow fracture                              A   8.80  10.02NA   9.51NA  10.02     9.51     1.67  20.49  19.98  20.49  19.98  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24640  Treat elbow dislocation                           A   1.25   2.14     2.36     1.08     1.18     0.23   3.62   3.84   2.56   2.66  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
24650  Treat radius fracture                             A   2.31   4.55     4.78     3.91     4.20     0.42   7.28   7.51   6.64   6.93  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24655  Treat radius fracture                             A   4.62   6.86     7.12     5.83     6.10     0.86  12.34  12.60  11.31  11.58  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24665  Treat radius fracture                             A   8.36   8.94NA   9.40NA   8.94     9.40     1.59  18.89  19.35  18.89  19.35  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24666  Treat radius fracture                             A   9.86   9.60NA  10.08NA   9.60    10.08     1.86  21.32  21.80  21.32  21.80  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24670  Treat ulnar fracture                              A   2.69   4.95     5.19     4.15     4.42     0.50   8.14   8.38   7.34   7.61  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24675  Treat ulnar fracture                              A   4.91   7.16     7.48     6.11     6.41     0.92  12.99  13.31  11.94  12.24  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
24685  Treat ulnar fracture                              A   8.37   8.94NA   9.39NA   8.94     9.39     1.62  18.93  19.38  18.93  19.38  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24800  Fusion of elbow joint                             A  11.41  10.11NA  11.06NA  10.11    11.06     2.24  23.76  24.71  23.76  24.71  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24802  Fusion/graft of elbow joint                       A  14.32  12.13NA  12.80NA  12.13    12.80     2.82  29.27  29.94  29.27  29.94  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24900  Amputation of upper arm                           A  10.18   9.01NA   9.63NA   9.01     9.63     2.01  21.20  21.82  21.20  21.82  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24920  Amputation of upper arm                           A  10.13   8.96NA   9.71NA   8.96     9.71     1.98  21.07  21.82  21.07  21.82  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
24925  Amputation follow-up surgery                      A   7.30   7.60NA   8.02NA   7.60     8.02     1.44  16.34  16.76  16.34  16.76  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24930  Amputation follow-up surgery                      A  10.83   9.38NA  10.13NA   9.38    10.13     2.13  22.34  23.09  22.34  23.09  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24931  Amputate upper arm & implant                      A  13.44   8.18NA   8.42NA   8.18     8.42     0.95  22.57  22.81  22.57  22.81  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24935  Revision of amputation                            A  16.45   8.56NA   7.58NA   8.56     7.58     3.23  28.24  27.26  28.24  27.26  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
24940  Revision of upper arm                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
24999  Upper arm/elbow surgery                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
25000  Incision of tendon sheath                         A   3.55   5.75NA   5.68NA   5.75     5.68     0.64   9.94   9.87   9.94   9.87  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25001  Incise flexor carpi radialis                      A   3.79   5.33NA   5.69NA   5.33     5.69     0.67   9.79  10.15   9.79  10.15  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25020  Decompress forearm 1 space                        A   6.06   9.60NA   9.89NA   9.60     9.89     1.06  16.72  17.01  16.72  17.01  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25023  Decompress forearm 1 space                        A  13.83  15.61NA  16.21NA  15.61    16.21     2.73  32.17  32.77  32.17  32.77  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25024  Decompress forearm 2 spaces                       A  10.79   9.76NA  10.27NA   9.76    10.27     2.12  22.67  23.18  22.67  23.18  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25025  Decompress forearm 2 spaces                       A  17.94  14.03NA  15.28NA  14.03    15.28     3.53  35.50  36.75  35.50  36.75  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25028  Drainage of forearm lesion                        A   5.39   8.57NA   8.82NA   8.57     8.82     1.03  14.99  15.24  14.99  15.24  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25031  Drainage of forearm bursa                         A   4.26   5.44NA   5.14NA   5.44     5.14     0.83  10.53  10.23  10.53  10.23  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25035  Treat forearm bone lesion                         A   7.65   8.80NA   8.19NA   8.80     8.19     1.48  17.93  17.32  17.93  17.32  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25040  Explore/treat wrist joint                         A   7.50   7.61NA   7.85NA   7.61     7.85     1.36  16.47  16.71  16.47  16.71  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25065  Biopsy forearm soft tissues                       A   2.04   5.00     5.12     2.49     2.58     0.33   7.37   7.49   4.86   4.95  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
25066  Biopsy forearm soft tissues                       A   4.27   5.62NA   5.48NA   5.62     5.48     0.80  10.69  10.55  10.69  10.55  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25071  Exc forearm les sc > 3 cm                         A   5.91   5.71NA   5.71NA   5.71     5.71     1.17  12.79  12.79  12.79  12.79  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25073  Exc forearm tum deep 3+ cm                        A   7.13   7.50NA   7.50NA   7.50     7.50     1.36  15.99  15.99  15.99  15.99  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25075  Exc forearm les sc < 3 cm                         A   3.96   9.20     9.20     4.77     4.66     0.76  13.92  13.92   9.49   9.38  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25076  Exc forearm tum deep < 3 cm                       A   6.74   7.03NA   7.27NA   7.03     7.27     1.28  15.05  15.29  15.05  15.29  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25077  Resect forearm/wrist tum<3cm                      A  12.93  10.24NA  10.93NA  10.24    10.93     2.61  25.78  26.47  25.78  26.47  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25078  Resect forearm/wrist tum3+cm                      A  17.69  11.98NA  11.98NA  11.98    11.98     3.78  33.45  33.45  33.45  33.45  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25085  Incision of wrist capsule                         A   5.64   6.57NA   6.62NA   6.57     6.62     1.10  13.31  13.36  13.31  13.36  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25100  Biopsy of wrist joint                             A   4.02   5.23NA   5.36NA   5.23     5.36     0.77  10.02  10.15  10.02  10.15  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25101  Explore/treat wrist joint                         A   4.83   6.03NA   6.20NA   6.03     6.20     0.90  11.76  11.93  11.76  11.93  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25105  Remove wrist joint lining                         A   6.02   7.05NA   7.18NA   7.05     7.18     1.10  14.17  14.30  14.17  14.30  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
25107  Remove wrist joint cartilage                      A   7.70   8.91NA   9.26NA   8.91     9.26     1.36  17.97  18.32  17.97  18.32  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25109  Excise tendon forearm/wrist                       A   6.94   7.28NA   7.84NA   7.28     7.84     1.24  15.46  16.02  15.46  16.02  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25110  Remove wrist tendon lesion                        A   4.04   5.39NA   5.22NA   5.39     5.22     0.75  10.18  10.01  10.18  10.01  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25111  Remove wrist tendon lesion                        A   3.53   5.01NA   5.19NA   5.01     5.19     0.67   9.21   9.39   9.21   9.39  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25112  Reremove wrist tendon lesion                      A   4.67   5.63NA   5.87NA   5.63     5.87     0.87  11.17  11.41  11.17  11.41  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25115  Remove wrist/forearm lesion                       A  10.09  11.04NA  10.83NA  11.04    10.83     1.79  22.92  22.71  22.92  22.71  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25116  Remove wrist/forearm lesion                       A   7.56   9.38NA   8.95NA   9.38     8.95     1.33  18.27  17.84  18.27  17.84  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
25118  Excise wrist tendon sheath                        A   4.51   5.80NA   5.97NA   5.80     5.97     0.80  11.11  11.28  11.11  11.28  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25119  Partial removal of ulna                           A   6.21   7.20NA   7.29NA   7.20     7.29     1.22  14.63  14.72  14.63  14.72  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25120  Removal of forearm lesion                         A   6.27   7.91NA   7.32NA   7.91     7.32     1.17  15.35  14.76  15.35  14.76  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
25125  Remove/graft forearm lesion                       A   7.67   8.95NA   8.39NA   8.95     8.39     1.51  18.13  17.57  18.13  17.57  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25126  Remove/graft forearm lesion                       A   7.74   8.94NA   8.43NA   8.94     8.43     1.52  18.20  17.69  18.20  17.69  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25130  Removal of wrist lesion                           A   5.43   6.66NA   6.88NA   6.66     6.88     0.99  13.08  13.30  13.08  13.30  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25135  Remove & graft wrist lesion                       A   7.08   7.84NA   8.03NA   7.84     8.03     1.39  16.31  16.50  16.31  16.50  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25136  Remove & graft wrist lesion                       A   6.14   7.01NA   7.21NA   7.01     7.21     1.21  14.36  14.56  14.36  14.56  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25145  Remove forearm bone lesion                        A   6.54   8.04NA   7.46NA   8.04     7.46     1.28  15.86  15.28  15.86  15.28  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25150  Partial removal of ulna                           A   7.38   7.91NA   8.04NA   7.91     8.04     1.36  16.65  16.78  16.65  16.78  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
25151  Partial removal of radius                         A   7.68   8.71NA   8.18NA   8.71     8.18     1.51  17.90  17.37  17.90  17.37  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25170  Resect radius/ulnar tumor                         A  22.21  14.89NA  17.89NA  14.89    17.89     4.36  41.46  44.46  41.46  44.46  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25210  Removal of wrist bone                             A   6.12   7.08NA   7.32NA   7.08     7.32     1.07  14.27  14.51  14.27  14.51  0090.10.69.2120010             25.5217 090 99      0.00   0.00   0.00
25215  Removal of wrist bones                            A   8.14   8.64NA   8.86NA   8.64     8.86     1.40  18.18  18.40  18.18  18.40  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
25230  Partial removal of radius                         A   5.37   6.31NA   6.52NA   6.31     6.52     0.90  12.58  12.79  12.58  12.79  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
25240  Partial removal of ulna                           A   5.31   6.40NA   6.45NA   6.40     6.45     0.91  12.62  12.67  12.62  12.67  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
25246  Injection for wrist x-ray                         A   1.45   3.24     2.94     0.63     0.59     0.14   4.83   4.53   2.22   2.18  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
25248  Remove forearm foreign body                       A   5.31   6.09NA   5.82NA   6.09     5.82     1.05  12.45  12.18  12.45  12.18  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25250  Removal of wrist prosthesis                       A   6.77   7.23NA   7.58NA   7.23     7.58     1.32  15.32  15.67  15.32  15.67  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25251  Removal of wrist prosthesis                       A   9.82   9.21NA   9.66NA   9.21     9.66     1.93  20.96  21.41  20.96  21.41  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
25259  Manipulate wrist w/anesthes                       A   4.04   6.94NA   7.31NA   6.94     7.31     0.72  11.70  12.07  11.70  12.07  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25260  Repair forearm tendon/muscle                      A   8.04   9.65NA   9.25NA   9.65     9.25     1.48  19.17  18.77  19.17  18.77  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
25263  Repair forearm tendon/muscle                      A   8.04   9.48NA   8.95NA   9.48     8.95     1.58  19.10  18.57  19.10  18.57  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
25265  Repair forearm tendon/muscle                      A  10.10  10.64NA  10.18NA  10.64    10.18     1.97  22.71  22.25  22.71  22.25  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
25270  Repair forearm tendon/muscle                      A   6.17   7.85NA   7.29NA   7.85     7.29     1.15  15.17  14.61  15.17  14.61  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
25272  Repair forearm tendon/muscle                      A   7.21   8.51NA   7.94NA   8.51     7.94     1.32  17.04  16.47  17.04  16.47  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
25274  Repair forearm tendon/muscle                      A   8.94   9.69NA   9.15NA   9.69     9.15     1.77  20.40  19.86  20.40  19.86  0090.10.69.2120010             25.5217 090 99      0.00   0.00   0.00
25275  Repair forearm tendon sheath                      A   8.96   8.93NA   9.32NA   8.93     9.32     1.77  19.66  20.05  19.66  20.05  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
25280  Revise wrist/forearm tendon                       A   7.39   8.61NA   8.09NA   8.61     8.09     1.28  17.28  16.76  17.28  16.76  0090.10.69.2120010             25.5217 090 99      0.00   0.00   0.00
25290  Incise wrist/forearm tendon                       A   5.43   7.68NA   6.53NA   7.68     6.53     0.98  14.09  12.94  14.09  12.94  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
25295  Release wrist/forearm tendon                      A   6.72   8.18NA   7.65NA   8.18     7.65     1.18  16.08  15.55  16.08  15.55  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
25300  Fusion of tendons at wrist                        A   9.02   9.20NA   9.52NA   9.20     9.52     1.78  20.00  20.32  20.00  20.32  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25301  Fusion of tendons at wrist                        A   8.59   8.69NA   9.01NA   8.69     9.01     1.56  18.84  19.16  18.84  19.16  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25310  Transplant forearm tendon                         A   8.08   9.36NA   8.94NA   9.36     8.94     1.39  18.83  18.41  18.83  18.41  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
25312  Transplant forearm tendon                         A   9.82  10.26NA   9.84NA  10.26     9.84     1.78  21.86  21.44  21.86  21.44  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
25315  Revise palsy hand tendon(s)                       A  10.68  10.69NA  10.19NA  10.69    10.19     2.09  23.46  22.96  23.46  22.96  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25316  Revise palsy hand tendon(s)                       A  12.90  12.10NA  11.84NA  12.10    11.84     1.60  26.60  26.34  26.60  26.34  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25320  Repair/revise wrist joint                         A  12.75  13.64NA  14.46NA  13.64    14.46     2.25  28.64  29.46  28.64  29.46  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25332  Revise wrist joint                                A  11.74  10.74NA  11.35NA  10.74    11.35     2.17  24.65  25.26  24.65  25.26  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25335  Realignment of hand                               A  13.39  10.04NA   8.62NA  10.04     8.62     0.95  24.38  22.96  24.38  22.96  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25337  Reconstruct ulna/radioulnar                       A  11.73  12.22NA  12.81NA  12.22    12.81     2.01  25.96  26.55  25.96  26.55  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25350  Revision of radius                                A   9.09   9.86NA   9.35NA   9.86     9.35     1.60  20.55  20.04  20.55  20.04  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25355  Revision of radius                                A  10.53  10.70NA  10.21NA  10.70    10.21     2.06  23.29  22.80  23.29  22.80  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25360  Revision of ulna                                  A   8.74   9.61NA   9.04NA   9.61     9.04     1.64  19.99  19.42  19.99  19.42  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25365  Revise radius & ulna                              A  12.91  12.13NA  11.86NA  12.13    11.86     2.54  27.58  27.31  27.58  27.31  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25370  Revise radius or ulna                             A  14.10  13.35NA  13.15NA  13.35    13.15     2.77  30.22  30.02  30.22  30.02  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25375  Revise radius & ulna                              A  13.55  12.65NA  12.24NA  12.65    12.24     0.95  27.15  26.74  27.15  26.74  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25390  Shorten radius or ulna                            A  10.70  10.81NA  10.41NA  10.81    10.41     1.87  23.38  22.98  23.38  22.98  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25391  Lengthen radius or ulna                           A  14.28  12.98NA  12.68NA  12.98    12.68     2.82  30.08  29.78  30.08  29.78  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25392  Shorten radius & ulna                             A  14.58  13.18NA  12.86NA  13.18    12.86     2.89  30.65  30.33  30.65  30.33  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25393  Lengthen radius & ulna                            A  16.56  15.06NA  15.48NA  15.06    15.48     3.27  34.89  35.31  34.89  35.31  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25394  Repair carpal bone shorten                        A  10.85   9.84NA  10.36NA   9.84    10.36     2.13  22.82  23.34  22.82  23.34  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25400  Repair radius or ulna                             A  11.28  11.13NA  10.65NA  11.13    10.65     2.06  24.47  23.99  24.47  23.99  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25405  Repair/graft radius or ulna                       A  15.01  13.58NA  13.26NA  13.58    13.26     2.73  31.32  31.00  31.32  31.00  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25415  Repair radius & ulna                              A  13.80  13.18NA  12.89NA  13.18    12.89     2.72  29.70  29.41  29.70  29.41  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25420  Repair/graft radius & ulna                        A  17.04  14.90NA  14.58NA  14.90    14.58     3.37  35.31  34.99  35.31  34.99  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25425  Repair/graft radius or ulna                       A  13.72  13.45NA  12.34NA  13.45    12.34     2.70  29.87  28.76  29.87  28.76  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25426  Repair/graft radius & ulna                        A  16.45  13.18NA  13.98NA  13.18    13.98     3.23  32.86  33.66  32.86  33.66  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25430  Vasc graft into carpal bone                       A   9.71   9.50NA  10.10NA   9.50    10.10     1.21  20.42  21.02  20.42  21.02  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25431  Repair nonunion carpal bone                       A  10.89   9.86NA  10.47NA   9.86    10.47     2.15  22.90  23.51  22.90  23.51  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25440  Repair/graft wrist bone                           A  10.68   9.93NA  10.30NA   9.93    10.30     1.89  22.50  22.87  22.50  22.87  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25441  Reconstruct wrist joint                           A  13.29  12.14NA  13.19NA  12.14    13.19     1.64  27.07  28.12  27.07  28.12  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25442  Reconstruct wrist joint                           A  11.12  10.50NA  11.08NA  10.50    11.08     1.39  23.01  23.59  23.01  23.59  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25443  Reconstruct wrist joint                           A  10.66  10.05NA  10.49NA  10.05    10.49     2.09  22.80  23.24  22.80  23.24  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25444  Reconstruct wrist joint                           A  11.42  10.92NA  11.87NA  10.92    11.87     0.80  23.14  24.09  23.14  24.09  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25445  Reconstruct wrist joint                           A   9.88   9.32NA   9.82NA   9.32     9.82     1.79  20.99  21.49  20.99  21.49  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
25446  Wrist replacement                                 A  17.30  14.10NA  14.94NA  14.10    14.94     2.95  34.35  35.19  34.35  35.19  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25447  Repair wrist joint(s)                             A  11.14  10.88NA  11.59NA  10.88    11.59     1.96  23.98  24.69  23.98  24.69  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25449  Remove wrist joint implant                        A  14.94  12.69NA  13.51NA  12.69    13.51     2.95  30.58  31.40  30.58  31.40  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25450  Revision of wrist joint                           A   8.06   6.83NA   6.05NA   6.83     6.05     1.58  16.47  15.69  16.47  15.69  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25455  Revision of wrist joint                           A   9.71   7.75NA   7.00NA   7.75     7.00     0.68  18.14  17.39  18.14  17.39  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25490  Reinforce radius                                  A   9.73   9.56NA   8.85NA   9.56     8.85     1.25  20.54  19.83  20.54  19.83  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25491  Reinforce ulna                                    A  10.15  10.39NA   9.88NA  10.39     9.88     1.98  22.52  22.01  22.52  22.01  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25492  Reinforce radius and ulna                         A  12.66  12.13NA  11.82NA  12.13    11.82     2.47  27.26  26.95  27.26  26.95  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25500  Treat fracture of radius                          A   2.60   4.45     4.75     3.82     4.14     0.45   7.50   7.80   6.87   7.19  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25505  Treat fracture of radius                          A   5.45   7.79     8.14     6.67     7.01     1.03  14.27  14.62  13.15  13.49  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25515  Treat fracture of radius                          A   8.80   8.91NA   9.37NA   8.91     9.37     1.67  19.38  19.84  19.38  19.84  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25520  Treat fracture of radius                          A   6.50   8.20     8.88     7.42     8.08     1.28  15.98  16.66  15.20  15.86  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25525  Treat fracture of radius                          A  10.55  10.45NA  10.76NA  10.45    10.76     2.01  23.01  23.32  23.01  23.32  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
25526  Treat fracture of radius                          A  13.15  12.60NA  12.72NA  12.60    12.72     2.59  28.34  28.46  28.34  28.46  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
25530  Treat fracture of ulna                            A   2.24   4.62     4.86     3.91     4.19     0.41   7.27   7.51   6.56   6.84  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25535  Treat fracture of ulna                            A   5.36   7.51     7.92     6.57     6.94     1.02  13.89  14.30  12.95  13.32  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25545  Treat fracture of ulna                            A   7.94   8.63NA   8.99NA   8.63     8.99     1.51  18.08  18.44  18.08  18.44  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25560  Treat fracture radius & ulna                      A   2.59   4.55     4.83     3.80     4.13     0.48   7.62   7.90   6.87   7.20  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25565  Treat fracture radius & ulna                      A   5.85   7.95     8.30     6.64     6.97     1.10  14.90  15.25  13.59  13.92  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25574  Treat fracture radius & ulna                      A   8.80   8.94NA   9.44NA   8.94     9.44     1.70  19.44  19.94  19.44  19.94  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
25575  Treat fracture radius/ulna                        A  12.29  11.52NA  12.13NA  11.52    12.13     2.34  26.15  26.76  26.15  26.76  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25600  Treat fracture radius/ulna                        A   2.78   4.90     5.14     4.16     4.46     0.52   8.20   8.44   7.46   7.76  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25605  Treat fracture radius/ulna                        A   7.25   9.14     9.66     8.17     8.68     1.39  17.78  18.30  16.81  17.32  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25606  Treat fx distal radial                            A   8.31   9.39NA   9.70NA   9.39     9.70     1.60  19.30  19.61  19.30  19.61  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25607  Treat fx rad extra-articul                        A   9.56   9.77NA  10.45NA   9.77    10.45     1.82  21.15  21.83  21.15  21.83  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25608  Treat fx rad intra-articul                        A  11.07  10.63NA  11.37NA  10.63    11.37     2.06  23.76  24.50  23.76  24.50  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25609  Treat fx radial 3+ frag                           A  14.38  13.24NA  14.20NA  13.24    14.20     2.69  30.31  31.27  30.31  31.27  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25622  Treat wrist bone fracture                         A   2.79   5.18     5.46     4.39     4.73     0.52   8.49   8.77   7.70   8.04  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25624  Treat wrist bone fracture                         A   4.77   7.45     7.73     6.31     6.60     0.88  13.10  13.38  11.96  12.25  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25628  Treat wrist bone fracture                         A   9.67   9.50NA  10.03NA   9.50    10.03     1.74  20.91  21.44  20.91  21.44  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25630  Treat wrist bone fracture                         A   3.03   5.00     5.25     4.24     4.58     0.56   8.59   8.84   7.83   8.17  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25635  Treat wrist bone fracture                         A   4.61   7.20     7.75     5.98     6.66     0.90  12.71  13.26  11.49  12.17  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25645  Treat wrist bone fracture                         A   7.42   7.60NA   7.98NA   7.60     7.98     1.47  16.49  16.87  16.49  16.87  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25650  Treat wrist bone fracture                         A   3.23   5.18     5.46     4.55     4.93     0.60   9.01   9.29   8.38   8.76  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25651  Pin ulnar styloid fracture                        A   5.82   7.00NA   7.45NA   7.00     7.45     1.10  13.92  14.37  13.92  14.37  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25652  Treat fracture ulnar styloid                      A   8.06   8.49NA   8.97NA   8.49     8.97     1.47  18.02  18.50  18.02  18.50  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
25660  Treat wrist dislocation                           A   4.98   5.69NA   5.93NA   5.69     5.93     0.90  11.57  11.81  11.57  11.81  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25670  Treat wrist dislocation                           A   8.09   8.01NA   8.33NA   8.01     8.33     1.49  17.59  17.91  17.59  17.91  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25671  Pin radioulnar dislocation                        A   6.46   7.54NA   8.00NA   7.54     8.00     1.26  15.26  15.72  15.26  15.72  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25675  Treat wrist dislocation                           A   4.89   6.53     6.85     5.54     5.84     0.87  12.29  12.61  11.30  11.60  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25676  Treat wrist dislocation                           A   8.29   8.50NA   8.94NA   8.50     8.94     1.53  18.32  18.76  18.32  18.76  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25680  Treat wrist fracture                              A   6.23   5.99NA   6.36NA   5.99     6.36     1.07  13.29  13.66  13.29  13.66  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25685  Treat wrist fracture                              A  10.09   9.30NA   9.83NA   9.30     9.83     1.97  21.36  21.89  21.36  21.89  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25690  Treat wrist dislocation                           A   5.72   6.80NA   7.30NA   6.80     7.30     1.14  13.66  14.16  13.66  14.16  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25695  Treat wrist dislocation                           A   8.51   8.24NA   8.63NA   8.24     8.63     1.66  18.41  18.80  18.41  18.80  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25800  Fusion of wrist joint                             A  10.07   9.61NA   9.95NA   9.61     9.95     1.81  21.49  21.83  21.49  21.83  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25805  Fusion/graft of wrist joint                       A  11.73  10.84NA  11.14NA  10.84    11.14     2.30  24.87  25.17  24.87  25.17  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25810  Fusion/graft of wrist joint                       A  11.95  11.28NA  11.87NA  11.28    11.87     2.12  25.35  25.94  25.35  25.94  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25820  Fusion of hand bones                              A   7.64   8.80NA   9.20NA   8.80     9.20     1.37  17.81  18.21  17.81  18.21  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25825  Fuse hand bones with graft                        A   9.69  10.60NA  11.12NA  10.60    11.12     1.68  21.97  22.49  21.97  22.49  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25830  Fusion radioulnar jnt/ulna                        A  10.88  14.66NA  15.00NA  14.66    15.00     2.15  27.69  28.03  27.69  28.03  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
25900  Amputation of forearm                             A   9.61   9.96NA   9.76NA   9.96     9.76     1.82  21.39  21.19  21.39  21.19  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25905  Amputation of forearm                             A   9.59   9.60NA   9.40NA   9.60     9.40     1.89  21.08  20.88  21.08  20.88  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25907  Amputation follow-up surgery                      A   8.09   8.76NA   8.50NA   8.76     8.50     1.59  18.44  18.18  18.44  18.18  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25909  Amputation follow-up surgery                      A   9.31   9.48NA   9.23NA   9.48     9.23     1.83  20.62  20.37  20.62  20.37  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25915  Amputation of forearm                             A  17.52  12.60NA  10.17NA  12.60    10.17     3.10  33.22  30.79  33.22  30.79  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25920  Amputate hand at wrist                            A   9.03   9.34NA   9.84NA   9.34     9.84     1.78  20.15  20.65  20.15  20.65  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25922  Amputate hand at wrist                            A   7.65   6.84NA   6.22NA   6.84     6.22     0.53  15.02  14.40  15.02  14.40  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25924  Amputation follow-up surgery                      A   8.81   8.14NA   7.66NA   8.14     7.66     1.71  18.66  18.18  18.66  18.18  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25927  Amputation of hand                                A   9.09  12.30NA  12.92NA  12.30    12.92     1.79  23.18  23.80  23.18  23.80  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
25929  Amputation follow-up surgery                      A   7.82   7.82NA   8.94NA   7.82     8.94     1.53  17.17  18.29  17.17  18.29  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
25931  Amputation follow-up surgery                      A   8.04  10.47NA  10.00NA  10.47    10.00     1.70  20.21  19.74  20.21  19.74  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
25999  Forearm or wrist surgery                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
26010  Drainage of finger abscess                        A   1.59   5.47     5.52     2.04     2.16     0.27   7.33   7.38   3.90   4.02  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
26011  Drainage of finger abscess                        A   2.24   8.46     8.50     2.70     2.84     0.39  11.09  11.13   5.33   5.47  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
26020  Drain hand tendon sheath                          A   5.08   6.47NA   6.84NA   6.47     6.84     0.92  12.47  12.84  12.47  12.84  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26025  Drainage of palm bursa                            A   5.08   6.11NA   6.48NA   6.11     6.48     0.91  12.10  12.47  12.10  12.47  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26030  Drainage of palm bursa(s)                         A   6.25   6.85NA   7.25NA   6.85     7.25     1.15  14.25  14.65  14.25  14.65  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26034  Treat hand bone lesion                            A   6.63   7.64NA   8.06NA   7.64     8.06     1.22  15.49  15.91  15.49  15.91  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26035  Decompress fingers/hand                           A  11.37  10.97NA  11.87NA  10.97    11.87     2.23  24.57  25.47  24.57  25.47  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26037  Decompress fingers/hand                           A   7.57   7.58NA   8.03NA   7.58     8.03     1.44  16.59  17.04  16.59  17.04  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26040  Release palm contracture                          A   3.46   4.88NA   5.16NA   4.88     5.16     0.56   8.90   9.18   8.90   9.18  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
26045  Release palm contracture                          A   5.73   6.67NA   7.00NA   6.67     7.00     1.09  13.49  13.82  13.49  13.82  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
26055  Incise finger tendon sheath                       A   3.11  12.47    12.31     5.09     5.42     0.56  16.14  15.98   8.76   9.09  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26060  Incision of finger tendon                         A   2.91   4.22NA   4.45NA   4.22     4.45     0.54   7.67   7.90   7.67   7.90  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26070  Explore/treat hand joint                          A   3.81   4.33NA   4.68NA   4.33     4.68     0.65   8.79   9.14   8.79   9.14  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
26075  Explore/treat finger joint                        A   3.91   4.65NA   4.95NA   4.65     4.95     0.67   9.23   9.53   9.23   9.53  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
26080  Explore/treat finger joint                        A   4.47   5.89NA   6.24NA   5.89     6.24     0.77  11.13  11.48  11.13  11.48  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26100  Biopsy hand joint lining                          A   3.79   4.95NA   5.29NA   4.95     5.29     0.73   9.47   9.81   9.47   9.81  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
26105  Biopsy finger joint lining                        A   3.83   5.03NA   5.31NA   5.03     5.31     0.75   9.61   9.89   9.61   9.89  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
26110  Biopsy finger joint lining                        A   3.65   4.91NA   5.21NA   4.91     5.21     0.64   9.20   9.50   9.20   9.50  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26111  Exc hand les sc > 1.5 cm                          A   5.42   6.09NA   6.09NA   6.09     6.09     0.99  12.50  12.50  12.50  12.50  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26113  Exc hand tum deep > 1.5 cm                        A   7.13   8.00NA   8.00NA   8.00     8.00     1.25  16.38  16.38  16.38  16.38  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26115  Exc hand les sc < 1.5 cm                          A   3.96  11.43     9.92     5.28     5.17     0.71  16.10  14.59   9.95   9.84  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26116  Exc hand tum deep < 1.5 cm                        A   6.74   7.29NA   7.75NA   7.29     7.75     1.20  15.23  15.69  15.23  15.69  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26117  Exc hand tum ra < 3 cm                            A  10.13   9.29NA  10.52NA   9.29    10.52     1.85  21.27  22.50  21.27  22.50  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26118  Exc hand tum ra > 3 cm                            A  14.81  14.28NA  14.28NA  14.28    14.28     2.93  32.02  32.02  32.02  32.02  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26121  Release palm contracture                          A   7.73   8.21NA   8.66NA   8.21     8.66     1.40  17.34  17.79  17.34  17.79  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
26123  Release palm contracture                          A  10.88  11.29NA  12.07NA  11.29    12.07     1.91  24.08  24.86  24.08  24.86  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
26125  Release palm contracture                          A   4.60   2.78NA   2.95NA   2.78     2.95     0.81   8.19   8.36   8.19   8.36  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
26130  Remove wrist joint lining                         A   5.59   6.62NA   7.05NA   6.62     7.05     1.06  13.27  13.70  13.27  13.70  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
26135  Revise finger joint each                          A   7.13   7.58NA   8.00NA   7.58     8.00     1.26  15.97  16.39  15.97  16.39  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26140  Revise finger joint each                          A   6.34   7.13NA   7.52NA   7.13     7.52     1.14  14.61  15.00  14.61  15.00  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26145  Tendon excision palm/finger                       A   6.49   7.16NA   7.55NA   7.16     7.55     1.18  14.83  15.22  14.83  15.22  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26160  Remove tendon sheath lesion                       A   3.57  12.16    12.27     5.27     5.61     0.65  16.38  16.49   9.49   9.83  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26170  Removal of palm tendon each                       A   4.91   5.94NA   6.27NA   5.94     6.27     0.86  11.71  12.04  11.71  12.04  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26180  Removal of finger tendon                          A   5.35   6.47NA   6.77NA   6.47     6.77     0.90  12.72  13.02  12.72  13.02  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26185  Remove finger bone                                A   6.52   7.90NA   8.41NA   7.90     8.41     1.28  15.70  16.21  15.70  16.21  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
26200  Remove hand bone lesion                           A   5.65   6.36NA   6.68NA   6.36     6.68     1.03  13.04  13.36  13.04  13.36  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26205  Remove/graft bone lesion                          A   7.93   8.01NA   8.36NA   8.01     8.36     1.56  17.50  17.85  17.50  17.85  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26210  Removal of finger lesion                          A   5.32   6.47NA   6.83NA   6.47     6.83     0.95  12.74  13.10  12.74  13.10  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26215  Remove/graft finger lesion                        A   7.27   7.55NA   7.96NA   7.55     7.96     1.44  16.26  16.67  16.26  16.67  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26230  Partial removal of hand bone                      A   6.47   6.88NA   7.22NA   6.88     7.22     1.13  14.48  14.82  14.48  14.82  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26235  Partial removal finger bone                       A   6.33   6.89NA   7.29NA   6.89     7.29     1.10  14.32  14.72  14.32  14.72  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26236  Partial removal finger bone                       A   5.46   6.31NA   6.64NA   6.31     6.64     0.98  12.75  13.08  12.75  13.08  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26250  Extensive hand surgery                            A  15.21  10.66NA  13.81NA  10.66    13.81     3.00  28.87  32.02  28.87  32.02  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26260  Resect prox finger tumor                          A  11.16   9.29NA  11.54NA   9.29    11.54     2.19  22.64  24.89  22.64  24.89  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26262  Resect distal finger tumor                        A   8.29   7.49NA   8.90NA   7.49     8.90     1.62  17.40  18.81  17.40  18.81  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26320  Removal of implant from hand                      A   4.10   5.18NA   5.48NA   5.18     5.48     0.71   9.99  10.29   9.99  10.29  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26340  Manipulate finger w/anesth                        A   2.80   6.08NA   6.43NA   6.08     6.43     0.52   9.40   9.75   9.40   9.75  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
26350  Repair finger/hand tendon                         A   6.21  13.17NA  13.12NA  13.17    13.12     1.13  20.51  20.46  20.51  20.46  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26352  Repair/graft hand tendon                          A   7.87  14.00NA  14.08NA  14.00    14.08     1.55  23.42  23.50  23.42  23.50  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26356  Repair finger/hand tendon                         A  10.62  18.76NA  19.20NA  18.76    19.20     1.91  31.29  31.73  31.29  31.73  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26357  Repair finger/hand tendon                         A   8.77  14.54NA  14.61NA  14.54    14.61     1.71  25.02  25.09  25.02  25.09  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26358  Repair/graft hand tendon                          A   9.36  15.51NA  15.80NA  15.51    15.80     1.85  26.72  27.01  26.72  27.01  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26370  Repair finger/hand tendon                         A   7.28  13.44NA  13.41NA  13.44    13.41     1.36  22.08  22.05  22.08  22.05  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26372  Repair/graft hand tendon                          A   9.01  14.80NA  14.76NA  14.80    14.76     1.78  25.59  25.55  25.59  25.55  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26373  Repair finger/hand tendon                         A   8.41  14.39NA  14.40NA  14.39    14.40     1.64  24.44  24.45  24.44  24.45  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26390  Revise hand/finger tendon                         A   9.43  12.76NA  13.01NA  12.76    13.01     1.86  24.05  24.30  24.05  24.30  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26392  Repair/graft hand tendon                          A  10.50  15.48NA  15.65NA  15.48    15.65     2.06  28.04  28.21  28.04  28.21  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26410  Repair hand tendon                                A   4.77  10.64NA  10.57NA  10.64    10.57     0.87  16.28  16.21  16.28  16.21  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26412  Repair/graft hand tendon                          A   6.48  12.10NA  12.12NA  12.10    12.12     1.15  19.73  19.75  19.73  19.75  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26415  Excision hand/finger tendon                       A   8.51  10.45NA  10.28NA  10.45    10.28     1.17  20.13  19.96  20.13  19.96  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26416  Graft hand or finger tendon                       A   9.56  12.74NA  14.37NA  12.74    14.37     1.87  24.17  25.80  24.17  25.80  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26418  Repair finger tendon                              A   4.47  11.24NA  11.21NA  11.24    11.21     0.81  16.52  16.49  16.52  16.49  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26420  Repair/graft finger tendon                        A   6.94  12.17NA  12.09NA  12.17    12.09     1.37  20.48  20.40  20.48  20.40  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26426  Repair finger/hand tendon                         A   6.32   8.15NA   7.42NA   8.15     7.42     1.14  15.61  14.88  15.61  14.88  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26428  Repair/graft finger tendon                        A   7.40  12.85NA  12.92NA  12.85    12.92     1.47  21.72  21.79  21.72  21.79  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26432  Repair finger tendon                              A   4.16   9.40NA   9.40NA   9.40     9.40     0.73  14.29  14.29  14.29  14.29  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26433  Repair finger tendon                              A   4.70   9.73NA   9.71NA   9.73     9.71     0.86  15.29  15.27  15.29  15.27  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26434  Repair/graft finger tendon                        A   6.26  11.00NA  11.11NA  11.00    11.11     1.24  18.50  18.61  18.50  18.61  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26437  Realignment of tendons                            A   5.99  10.86NA  10.96NA  10.86    10.96     1.03  17.88  17.98  17.88  17.98  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26440  Release palm/finger tendon                        A   5.16  11.84NA  11.73NA  11.84    11.73     0.90  17.90  17.79  17.90  17.79  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26442  Release palm & finger tendon                      A   9.75  16.19NA  16.56NA  16.19    16.56     1.74  27.68  28.05  27.68  28.05  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26445  Release hand/finger tendon                        A   4.45  11.43NA  11.29NA  11.43    11.29     0.77  16.65  16.51  16.65  16.51  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26449  Release forearm/hand tendon                       A   8.59  11.19NA  10.68NA  11.19    10.68     1.51  21.29  20.78  21.29  20.78  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26450  Incision of palm tendon                           A   3.79   7.13NA   7.22NA   7.13     7.22     0.68  11.60  11.69  11.60  11.69  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26455  Incision of finger tendon                         A   3.76   7.11NA   7.23NA   7.11     7.23     0.69  11.56  11.68  11.56  11.68  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26460  Incise hand/finger tendon                         A   3.58   7.04NA   7.17NA   7.04     7.17     0.62  11.24  11.37  11.24  11.37  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26471  Fusion of finger tendons                          A   5.90  10.74NA  10.87NA  10.74    10.87     1.03  17.67  17.80  17.67  17.80  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26474  Fusion of finger tendons                          A   5.49  10.67NA  10.88NA  10.67    10.88     1.07  17.23  17.44  17.23  17.44  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26476  Tendon lengthening                                A   5.35  10.46NA  10.78NA  10.46    10.78     1.06  16.87  17.19  16.87  17.19  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26477  Tendon shortening                                 A   5.32  10.40NA  10.50NA  10.40    10.50     1.02  16.74  16.84  16.74  16.84  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
26478  Lengthening of hand tendon                        A   5.97  10.91NA  10.90NA  10.91    10.90     1.09  17.97  17.96  17.97  17.96  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26479  Shortening of hand tendon                         A   5.91  10.84NA  10.90NA  10.84    10.90     1.17  17.92  17.98  17.92  17.98  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26480  Transplant hand tendon                            A   6.90  13.56NA  13.58NA  13.56    13.58     1.21  21.67  21.69  21.67  21.69  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26483  Transplant/graft hand tendon                      A   8.48  14.32NA  14.33NA  14.32    14.33     1.56  24.36  24.37  24.36  24.37  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26485  Transplant palm tendon                            A   7.89  14.05NA  14.04NA  14.05    14.04     1.40  23.34  23.33  23.34  23.33  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26489  Transplant/graft palm tendon                      A   9.86  14.41NA  15.27NA  14.41    15.27     1.93  26.20  27.06  26.20  27.06  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26490  Revise thumb tendon                               A   8.60  12.61NA  12.91NA  12.61    12.91     1.68  22.89  23.19  22.89  23.19  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26492  Tendon transfer with graft                        A   9.84  13.60NA  13.84NA  13.60    13.84     1.93  25.37  25.61  25.37  25.61  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26494  Hand tendon/muscle transfer                       A   8.66  12.63NA  12.80NA  12.63    12.80     1.68  22.97  23.14  22.97  23.14  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26496  Revise thumb tendon                               A   9.78  13.27NA  13.57NA  13.27    13.57     1.64  24.69  24.99  24.69  24.99  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26497  Finger tendon transfer                            A   9.76  13.25NA  13.46NA  13.25    13.46     1.91  24.92  25.13  24.92  25.13  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26498  Finger tendon transfer                            A  14.21  16.12NA  16.45NA  16.12    16.45     2.80  33.13  33.46  33.13  33.46  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26499  Revision of finger                                A   9.17  12.89NA  13.11NA  12.89    13.11     1.81  23.87  24.09  23.87  24.09  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26500  Hand tendon reconstruction                        A   6.13  10.80NA  10.91NA  10.80    10.91     1.14  18.07  18.18  18.07  18.18  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26502  Hand tendon reconstruction                        A   7.31  11.81NA  12.14NA  11.81    12.14     1.45  20.57  20.90  20.57  20.90  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26508  Release thumb contracture                         A   6.18  10.86NA  11.06NA  10.86    11.06     1.10  18.14  18.34  18.14  18.34  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26510  Thumb tendon transfer                             A   5.60  10.56NA  10.58NA  10.56    10.58     0.98  17.14  17.16  17.14  17.16  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26516  Fusion of knuckle joint                           A   7.32  11.56NA  11.69NA  11.56    11.69     1.29  20.17  20.30  20.17  20.30  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26517  Fusion of knuckle joints                          A   9.08  12.91NA  13.05NA  12.91    13.05     1.79  23.78  23.92  23.78  23.92  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26518  Fusion of knuckle joints                          A   9.27  13.11NA  13.39NA  13.11    13.39     1.82  24.20  24.48  24.20  24.48  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26520  Release knuckle contracture                       A   5.47  12.34NA  12.27NA  12.34    12.27     0.99  18.80  18.73  18.80  18.73  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26525  Release finger contracture                        A   5.50  12.36NA  12.27NA  12.36    12.27     0.95  18.81  18.72  18.81  18.72  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
26530  Revise knuckle joint                              A   6.88   7.42NA   7.85NA   7.42     7.85     1.22  15.52  15.95  15.52  15.95  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26531  Revise knuckle with implant                       A   8.13   8.54NA   9.05NA   8.54     9.05     1.39  18.06  18.57  18.06  18.57  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26535  Revise finger joint                               A   5.41   5.55NA   6.08NA   5.55     6.08     0.83  11.79  12.32  11.79  12.32  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26536  Revise/implant finger joint                       A   6.56  12.23NA  12.93NA  12.23    12.93     1.13  19.92  20.62  19.92  20.62  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26540  Repair hand joint                                 A   6.60  11.19NA  11.28NA  11.19    11.28     1.18  18.97  19.06  18.97  19.06  0090.10.69.2120010             25.5217 090 99      0.00   0.00   0.00
26541  Repair hand joint with graft                      A   8.81  12.70NA  12.82NA  12.70    12.82     1.52  23.03  23.15  23.03  23.15  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26542  Repair hand joint with graft                      A   6.95  11.44NA  11.55NA  11.44    11.55     1.25  19.64  19.75  19.64  19.75  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26545  Reconstruct finger joint                          A   7.11  11.68NA  11.87NA  11.68    11.87     1.26  20.05  20.24  20.05  20.24  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26546  Repair nonunion hand                              A  10.83  15.73NA  16.17NA  15.73    16.17     1.85  28.41  28.85  28.41  28.85  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
26548  Reconstruct finger joint                          A   8.22  12.32NA  12.53NA  12.32    12.53     1.49  22.03  22.24  22.03  22.24  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26550  Construct thumb replacement                       A  21.68  19.73NA  22.52NA  19.73    22.52     4.25  45.66  48.45  45.66  48.45  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26551  Great toe-hand transfer                           A  48.48  30.88NA  28.89NA  30.88    28.89     9.53  88.89  86.90  88.89  86.90  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26553  Single transfer toe-hand                          A  48.17  35.27NA  44.78NA  35.27    44.78     3.42  86.86  96.37  86.86  96.37  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26554  Double transfer toe-hand                          A  57.01  34.22NA  32.96NA  34.22    32.96     4.05  95.28  94.02  95.28  94.02  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26555  Positional change of finger                       A  17.08  19.31NA  19.76NA  19.31    19.76     3.37  39.76  40.21  39.76  40.21  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26556  Toe joint transfer                                A  49.75  29.48NA  32.53NA  29.48    32.53     3.95  83.18  86.23  83.18  86.23  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26560  Repair of web finger                              A   5.52  10.18NA  10.58NA  10.18    10.58     1.09  16.79  17.19  16.79  17.19  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26561  Repair of web finger                              A  11.10  13.92NA  15.02NA  13.92    15.02     2.35  27.37  28.47  27.37  28.47  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26562  Repair of web finger                              A  16.68  18.69NA  19.39NA  18.69    19.39     1.18  36.55  37.25  36.55  37.25  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26565  Correct metacarpal flaw                           A   6.91  11.30NA  11.40NA  11.30    11.40     1.36  19.57  19.67  19.57  19.67  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26567  Correct finger deformity                          A   6.99  11.35NA  11.43NA  11.35    11.43     1.24  19.58  19.66  19.58  19.66  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26568  Lengthen metacarpal/finger                        A   9.27  14.77NA  14.91NA  14.77    14.91     1.82  25.86  26.00  25.86  26.00  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26580  Repair hand deformity                             A  19.75  15.89NA  15.21NA  15.89    15.21     3.88  39.52  38.84  39.52  38.84  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26587  Reconstruct extra finger                          A  14.50  12.52NA  14.82NA  12.52    14.82     3.10  30.12  32.42  30.12  32.42  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26590  Repair finger deformity                           A  18.67  14.40NA  15.18NA  14.40    15.18     3.69  36.76  37.54  36.76  37.54  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26591  Repair muscles of hand                            A   3.38   8.58NA   8.49NA   8.58     8.49     0.61  12.57  12.48  12.57  12.48  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26593  Release muscles of hand                           A   5.50  10.76NA  10.87NA  10.76    10.87     0.92  17.18  17.29  17.18  17.29  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26596  Excision constricting tissue                      A   9.14  10.64NA  11.34NA  10.64    11.34     1.81  21.59  22.29  21.59  22.29  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26600  Treat metacarpal fracture                         A   2.60   5.01     5.37     4.48     4.91     0.48   8.09   8.45   7.56   7.99  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26605  Treat metacarpal fracture                         A   3.03   5.45     5.73     4.66     4.95     0.56   9.04   9.32   8.25   8.54  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26607  Treat metacarpal fracture                         A   5.48   6.38NA   6.96NA   6.38     6.96     1.06  12.92  13.50  12.92  13.50  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26608  Treat metacarpal fracture                         A   5.55   7.17NA   7.51NA   7.17     7.51     1.03  13.75  14.09  13.75  14.09  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26615  Treat metacarpal fracture                         A   7.07   8.03NA   8.75NA   8.03     8.75     1.29  16.39  17.11  16.39  17.11  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26641  Treat thumb dislocation                           A   4.13   5.35     5.44     4.52     4.66     0.72  10.20  10.29   9.37   9.51  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26645  Treat thumb fracture                              A   4.58   6.49     7.01     5.55     6.05     0.88  11.95  12.47  11.01  11.51  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26650  Treat thumb fracture                              A   5.35   7.40NA   7.71NA   7.40     7.71     1.02  13.77  14.08  13.77  14.08  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26665  Treat thumb fracture                              A   7.94   8.61NA   9.19NA   8.61     9.19     1.47  18.02  18.60  18.02  18.60  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
26670  Treat hand dislocation                            A   3.83   4.82     5.06     3.96     4.27     0.67   9.32   9.56   8.46   8.77  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26675  Treat hand dislocation                            A   4.83   6.95     7.49     5.97     6.48     0.95  12.73  13.27  11.75  12.26  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26676  Pin hand dislocation                              A   5.74   7.61NA   7.92NA   7.61     7.92     1.06  14.41  14.72  14.41  14.72  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26685  Treat hand dislocation                            A   7.07   8.11NA   8.66NA   8.11     8.66     1.39  16.57  17.12  16.57  17.12  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
26686  Treat hand dislocation                            A   8.17   8.28NA   8.71NA   8.28     8.71     1.60  18.05  18.48  18.05  18.48  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
26700  Treat knuckle dislocation                         A   3.83   4.43     4.68     3.87     4.19     0.65   8.91   9.16   8.35   8.67  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26705  Treat knuckle dislocation                         A   4.38   6.52     7.05     5.56     6.07     0.81  11.71  12.24  10.75  11.26  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26706  Pin knuckle dislocation                           A   5.31   6.34NA   6.80NA   6.34     6.80     0.95  12.60  13.06  12.60  13.06  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26715  Treat knuckle dislocation                         A   7.03   7.99NA   8.62NA   7.99     8.62     1.30  16.32  16.95  16.32  16.95  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26720  Treat finger fracture each                        A   1.76   3.39     3.57     2.98     3.20     0.33   5.48   5.66   5.07   5.29  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26725  Treat finger fracture each                        A   3.48   5.46     5.70     4.52     4.81     0.64   9.58   9.82   8.64   8.93  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26727  Treat finger fracture each                        A   5.42   7.12NA   7.46NA   7.12     7.46     0.99  13.53  13.87  13.53  13.87  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26735  Treat finger fracture each                        A   7.42   8.23NA   8.94NA   8.23     8.94     1.37  17.02  17.73  17.02  17.73  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26740  Treat finger fracture each                        A   2.07   3.96     4.21     3.57     3.82     0.35   6.38   6.63   5.99   6.24  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26742  Treat finger fracture each                        A   3.99   5.71     5.92     4.77     5.01     0.72  10.42  10.63   9.48   9.72  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26746  Treat finger fracture each                        A   9.80   9.55NA  10.54NA   9.55    10.54     1.78  21.13  22.12  21.13  22.12  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26750  Treat finger fracture each                        A   1.80   2.97     3.12     2.91     3.14     0.33   5.10   5.25   5.04   5.27  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26755  Treat finger fracture each                        A   3.23   5.00     5.20     3.89     4.12     0.58   8.81   9.01   7.70   7.93  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26756  Pin finger fracture each                          A   4.58   6.58NA   6.89NA   6.58     6.89     0.83  11.99  12.30  11.99  12.30  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26765  Treat finger fracture each                        A   5.86   7.19NA   7.91NA   7.19     7.91     1.09  14.14  14.86  14.14  14.86  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26770  Treat finger dislocation                          A   3.15   3.90     4.10     3.32     3.59     0.54   7.59   7.79   7.01   7.28  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26775  Treat finger dislocation                          A   3.90   6.18     6.48     5.14     5.50     0.69  10.77  11.07   9.73  10.09  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26776  Pin finger dislocation                            A   4.99   6.82NA   7.13NA   6.82     7.13     0.91  12.72  13.03  12.72  13.03  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26785  Treat finger dislocation                          A   6.60   7.61NA   8.41NA   7.61     8.41     1.21  15.42  16.22  15.42  16.22  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26820  Thumb fusion with graft                           A   8.45  12.57NA  12.68NA  12.57    12.68     1.66  22.68  22.79  22.68  22.79  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26841  Fusion of thumb                                   A   7.35  12.27NA  12.37NA  12.27    12.37     1.39  21.01  21.11  21.01  21.11  0090.10.69.2120010             25.5217 090 99      0.00   0.00   0.00
26842  Thumb fusion with graft                           A   8.49  12.63NA  12.73NA  12.63    12.73     1.66  22.78  22.88  22.78  22.88  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26843  Fusion of hand joint                              A   7.78  11.89NA  12.02NA  11.89    12.02     1.53  21.20  21.33  21.20  21.33  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26844  Fusion/graft of hand joint                        A   8.98  12.85NA  12.99NA  12.85    12.99     1.78  23.61  23.75  23.61  23.75  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26850  Fusion of knuckle                                 A   7.14  11.58NA  11.69NA  11.58    11.69     1.24  19.96  20.07  19.96  20.07  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26852  Fusion of knuckle with graft                      A   8.71  12.72NA  12.96NA  12.72    12.96     1.47  22.90  23.14  22.90  23.14  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26860  Fusion of finger joint                            A   4.88  10.43NA  10.49NA  10.43    10.49     0.84  16.15  16.21  16.15  16.21  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26861  Fusion of finger jnt add-on                       A   1.74   1.04NA   1.10NA   1.04     1.10     0.31   3.09   3.15   3.09   3.15  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
26862  Fusion/graft of finger joint                      A   7.56  12.01NA  12.20NA  12.01    12.20     1.30  20.87  21.06  20.87  21.06  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
26863  Fuse/graft added joint                            A   3.89   2.26NA   2.33NA   2.26     2.33     0.75   6.90   6.97   6.90   6.97  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
26910  Amputate metacarpal bone                          A   7.79  11.37NA  11.59NA  11.37    11.59     1.49  20.65  20.87  20.65  20.87  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26951  Amputation of finger/thumb                        A   6.04  11.26NA  11.67NA  11.26    11.67     1.14  18.44  18.85  18.44  18.85  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26952  Amputation of finger/thumb                        A   6.48  10.99NA  11.08NA  10.99    11.08     1.21  18.68  18.77  18.68  18.77  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26989  Hand/finger surgery                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020101             25.5217 090 99      0.00   0.00   0.00
26990  Drainage of pelvis lesion                         A   7.95   8.53NA   8.95NA   8.53     8.95     1.58  18.06  18.48  18.06  18.48  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
26991  Drainage of pelvis bursa                          A   7.06  11.86    12.23     6.76     7.18     1.39  20.31  20.68  15.21  15.63  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
26992  Drainage of bone lesion                           A  13.48  11.93NA  12.53NA  11.93    12.53     2.66  28.07  28.67  28.07  28.67  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
27000  Incision of hip tendon                            A   5.74   5.96NA   6.07NA   5.96     6.07     1.07  12.77  12.88  12.77  12.88  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27001  Incision of hip tendon                            A   7.14   7.16NA   7.50NA   7.16     7.50     1.40  15.70  16.04  15.70  16.04  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27003  Incision of hip tendon                            A   7.81   7.84NA   8.33NA   7.84     8.33     1.53  17.18  17.67  17.18  17.67  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27005  Incision of hip tendon                            A  10.07   9.17NA   9.61NA   9.17     9.61     1.97  21.21  21.65  21.21  21.65  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27006  Incision of hip tendons                           A  10.11   9.42NA   9.90NA   9.42     9.90     1.96  21.49  21.97  21.49  21.97  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27025  Incision of hip/thigh fascia                      A  12.89  11.07NA  11.82NA  11.07    11.82     2.57  26.53  27.28  26.53  27.28  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
27027  Buttock fasciotomy                                A  13.04  10.40NA  11.45NA  10.40    11.45     0.91  24.35  25.40  24.35  25.40  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27030  Drainage of hip joint                             A  13.65  11.14NA  11.57NA  11.14    11.57     2.66  27.45  27.88  27.45  27.88  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27033  Exploration of hip joint                          A  14.11  11.69NA  12.24NA  11.69    12.24     2.77  28.57  29.12  28.57  29.12  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27035  Denervation of hip joint                          A  17.37  12.73NA  14.53NA  12.73    14.53     3.42  33.52  35.32  33.52  35.32  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27036  Excision of hip joint/muscle                      A  14.38  12.27NA  12.91NA  12.27    12.91     2.78  29.43  30.07  29.43  30.07  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27040  Biopsy of soft tissues                            A   2.92   6.41     6.38     2.44     2.45     0.48   9.81   9.78   5.84   5.85  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
27041  Biopsy of soft tissues                            A  10.18   7.82NA   8.00NA   7.82     8.00     1.81  19.81  19.99  19.81  19.99  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27043  Exc hip pelvis les sc > 3 cm                      A   6.88   5.70NA   5.70NA   5.70     5.70     1.41  13.99  13.99  13.99  13.99  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27045  Exc hip/pelv tum deep > 5 cm                      A  11.13   8.82NA   8.82NA   8.82     8.82     2.25  22.20  22.20  22.20  22.20  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27047  Exc hip/pelvis les sc < 3 cm                      A   4.94   8.19     7.74     5.22     4.78     1.02  14.15  13.70  11.18  10.74  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27048  Exc hip/pelv tum deep < 5 cm                      A   8.85   6.69NA   7.53NA   6.69     7.53     1.81  17.35  18.19  17.35  18.19  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27049  Resect hip/pelv tum < 5 cm                        A  21.55  12.68NA  14.95NA  12.68    14.95     4.32  38.55  40.82  38.55  40.82  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27050  Biopsy of sacroiliac joint                        A   4.74   5.29NA   6.17NA   5.29     6.17     0.92  10.95  11.83  10.95  11.83  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
27052  Biopsy of hip joint                               A   7.42   7.65NA   8.18NA   7.65     8.18     1.47  16.54  17.07  16.54  17.07  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27054  Removal of hip joint lining                       A   9.21   8.88NA   9.34NA   8.88     9.34     1.81  19.90  20.36  19.90  20.36  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27057  Buttock fasciotomy w/dbrdmt                       A  14.91  11.42NA  12.57NA  11.42    12.57     1.06  27.39  28.54  27.39  28.54  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27059  Resect hip/pelv tum > 5 cm                        A  29.35  19.25NA  19.25NA  19.25    19.25     5.77  54.37  54.37  54.37  54.37  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27060  Removal of ischial bursa                          A   5.87   6.03NA   6.73NA   6.03     6.73     1.17  13.07  13.77  13.07  13.77  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27062  Remove femur lesion/bursa                         A   5.75   6.30NA   6.64NA   6.30     6.64     1.13  13.18  13.52  13.18  13.52  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27065  Remove hip bone les super                         A   6.55   6.82NA   7.14NA   6.82     7.14     1.28  14.65  14.97  14.65  14.97  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27066  Remove hip bone les deep                          A  11.20  10.26NA  10.81NA  10.26    10.81     2.20  23.66  24.21  23.66  24.21  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27067  Remove/graft hip bone lesion                      A  14.72  12.66NA  13.30NA  12.66    13.30     2.91  30.29  30.93  30.29  30.93  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27070  Part remove hip bone super                        A  11.56  10.99NA  11.52NA  10.99    11.52     2.27  24.82  25.35  24.82  25.35  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27071  Part removal hip bone deep                        A  12.39  11.76NA  12.28NA  11.76    12.28     2.43  26.58  27.10  26.58  27.10  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27075  Resect hip tumor                                  A  32.71  22.60NA  23.28NA  22.60    23.28     6.42  61.73  62.41  61.73  62.41  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27076  Resect hip tum incl acetabul                      A  40.21  22.53NA  28.22NA  22.53    28.22     7.92  70.66  76.35  70.66  76.35  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27077  Resect hip tum w/innom bone                       A  45.21  28.73NA  31.77NA  28.73    31.77     8.89  82.83  85.87  82.83  85.87  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27078  Rsect hip tum incl femur                          A  32.21  17.89NA  23.99NA  17.89    23.99     6.33  56.43  62.53  56.43  62.53  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27080  Removal of tail bone                              A   6.89   6.39NA   6.86NA   6.39     6.86     1.41  14.69  15.16  14.69  15.16  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27086  Remove hip foreign body                           A   1.92   4.86     4.91     2.05     2.12     0.31   7.09   7.14   4.28   4.35  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
27087  Remove hip foreign body                           A   8.83   7.83NA   8.14NA   7.83     8.14     1.70  18.36  18.67  18.36  18.67  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27090  Removal of hip prosthesis                         A  11.69  10.30NA  10.79NA  10.30    10.79     2.28  24.27  24.76  24.27  24.76  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27091  Removal of hip prosthesis                         A  24.35  17.88NA  18.96NA  17.88    18.96     4.79  47.02  48.10  47.02  48.10  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27093  Injection for hip x-ray                           A   1.30   4.15     4.03     0.64     0.66     0.14   5.59   5.47   2.08   2.10  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
27095  Injection for hip x-ray                           A   1.50   5.16     5.07     0.73     0.78     0.18   6.84   6.75   2.41   2.46  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
27096  Inject sacroiliac joint                           A   1.40   3.92     4.15     0.56     0.68     0.12   5.44   5.67   2.08   2.20  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
27097  Revision of hip tendon                            A   9.27   8.54NA   9.20NA   8.54     9.20     1.82  19.63  20.29  19.63  20.29  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27098  Transfer tendon to pelvis                         A   9.32   8.24NA   9.48NA   8.24     9.48     1.83  19.39  20.63  19.39  20.63  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27100  Transfer of abdominal muscle                      A  11.35  10.46NA  11.03NA  10.46    11.03     2.23  24.04  24.61  24.04  24.61  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27105  Transfer of spinal muscle                         A  12.04  10.89NA  11.44NA  10.89    11.44     2.35  25.28  25.83  25.28  25.83  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27110  Transfer of iliopsoas muscle                      A  13.77  11.70NA  12.47NA  11.70    12.47     2.72  28.19  28.96  28.19  28.96  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27111  Transfer of iliopsoas muscle                      A  12.60  10.58NA  11.77NA  10.58    11.77     2.46  25.64  26.83  25.64  26.83  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27120  Reconstruction of hip socket                      A  19.25  14.97NA  15.99NA  14.97    15.99     3.79  38.01  39.03  38.01  39.03  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27122  Reconstruction of hip socket                      A  16.09  13.11NA  13.76NA  13.11    13.76     3.15  32.35  33.00  32.35  33.00  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27125  Partial hip replacement                           A  16.64  13.30NA  14.08NA  13.30    14.08     3.27  33.21  33.99  33.21  33.99  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27130  Total hip arthroplasty                            A  21.79  16.38NA  17.26NA  16.38    17.26     4.28  42.45  43.33  42.45  43.33  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27132  Total hip arthroplasty                            A  25.69  18.81NA  19.77NA  18.81    19.77     5.05  49.55  50.51  49.55  50.51  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27134  Revise hip joint replacement                      A  30.28  20.77NA  21.71NA  20.77    21.71     5.95  57.00  57.94  57.00  57.94  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27137  Revise hip joint replacement                      A  22.70  16.48NA  17.27NA  16.48    17.27     4.45  43.63  44.42  43.63  44.42  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27138  Revise hip joint replacement                      A  23.70  17.04NA  17.87NA  17.04    17.87     4.66  45.40  46.23  45.40  46.23  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27140  Transplant femur ridge                            A  12.78  10.93NA  11.40NA  10.93    11.40     2.51  26.22  26.69  26.22  26.69  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27146  Incision of hip bone                              A  18.92  14.83NA  15.93NA  14.83    15.93     3.73  37.48  38.58  37.48  38.58  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27147  Revision of hip bone                              A  22.07  16.82NA  17.81NA  16.82    17.81     4.33  43.22  44.21  43.22  44.21  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27151  Incision of hip bones                             A  24.12  17.00NA  19.04NA  17.00    19.04     4.75  45.87  47.91  45.87  47.91  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27156  Revision of hip bones                             A  26.23  19.05NA  20.30NA  19.05    20.30     5.15  50.43  51.68  50.43  51.68  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27158  Revision of pelvis                                A  21.04  15.75NA  16.97NA  15.75    16.97     4.14  40.93  42.15  40.93  42.15  0090.10.69.2122200             25.5217 090 99      0.00   0.00   0.00
27161  Incision of neck of femur                         A  17.89  14.33NA  15.00NA  14.33    15.00     3.50  35.72  36.39  35.72  36.39  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27165  Incision/fixation of femur                        A  20.29  16.05NA  16.99NA  16.05    16.99     3.98  40.32  41.26  40.32  41.26  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27170  Repair/graft femur head/neck                      A  17.61  13.58NA  14.28NA  13.58    14.28     3.46  34.65  35.35  34.65  35.35  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27175  Treat slipped epiphysis                           A   9.38   8.23NA   8.69NA   8.23     8.69     1.85  19.46  19.92  19.46  19.92  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27176  Treat slipped epiphysis                           A  12.92  11.30NA  11.97NA  11.30    11.97     2.55  26.77  27.44  26.77  27.44  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27177  Treat slipped epiphysis                           A  16.09  13.37NA  14.12NA  13.37    14.12     3.16  32.62  33.37  32.62  33.37  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27178  Treat slipped epiphysis                           A  12.92  11.21NA  11.97NA  11.21    11.97     2.55  26.68  27.44  26.68  27.44  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27179  Revise head/neck of femur                         A  13.97  11.83NA  12.48NA  11.83    12.48     2.74  28.54  29.19  28.54  29.19  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27181  Treat slipped epiphysis                           A  16.18  13.40NA  14.29NA  13.40    14.29     3.19  32.77  33.66  32.77  33.66  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27185  Revision of femur epiphysis                       A   9.79   7.08NA   6.81NA   7.08     6.81     0.69  17.56  17.29  17.56  17.29  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27187  Reinforce hip bones                               A  14.23  12.06NA  12.61NA  12.06    12.61     2.80  29.09  29.64  29.09  29.64  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27193  Treat pelvic ring fracture                        A   6.09   6.31     6.67     6.46     6.84     1.20  13.60  13.96  13.75  14.13  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
27194  Treat pelvic ring fracture                        A  10.20   8.38NA   8.55NA   8.38     8.55     1.66  20.24  20.41  20.24  20.41  0090.10.69.2120020             25.5217 090 99      0.00   0.00   0.00
27200  Treat tail bone fracture                          A   1.92   2.78     2.97     2.94     3.17     0.35   5.05   5.24   5.21   5.44  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
27202  Treat tail bone fracture                          A   7.31   8.79NA   7.86NA   8.79     7.86     1.45  17.55  16.62  17.55  16.62  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
27215  Treat pelvic fracture(s)                          I+ 10.45   7.40NA   6.58NA   7.40     6.58     0.73  18.58  17.76  18.58  17.76  9090.10.69.2199999             25.5217 090 99      0.00   0.00   0.00
27216  Treat pelvic ring fracture                        I+ 15.73  10.60NA   9.53NA  10.60     9.53     1.13  27.46  26.39  27.46  26.39  9090.10.69.2199999             25.5217 090 99      0.00   0.00   0.00
27217  Treat pelvic ring fracture                        I+ 14.65  10.23NA   9.05NA  10.23     9.05     1.05  25.93  24.75  25.93  24.75  9090.10.69.2199999             25.5217 090 99      0.00   0.00   0.00
27218  Treat pelvic ring fracture                        I+ 20.93  13.06NA  11.82NA  13.06    11.82     1.49  35.48  34.24  35.48  34.24  9090.10.69.2199999             25.5217 090 99      0.00   0.00   0.00
27220  Treat hip socket fracture                         A   6.83   7.14     7.55     7.02     7.42     1.33  15.30  15.71  15.18  15.58  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27222  Treat hip socket fracture                         A  14.11  11.73NA  12.27NA  11.73    12.27     2.76  28.60  29.14  28.60  29.14  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27226  Treat hip wall fracture                           A  15.57  12.13NA  13.18NA  12.13    13.18     3.07  30.77  31.82  30.77  31.82  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27227  Treat hip fracture(s)                             A  25.41  18.71NA  19.72NA  18.71    19.72     5.00  49.12  50.13  49.12  50.13  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27228  Treat hip fracture(s)                             A  29.33  20.97NA  22.01NA  20.97    22.01     5.77  56.07  57.11  56.07  57.11  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27230  Treat thigh fracture                              A   5.81   6.69     7.03     6.55     6.94     1.14  13.64  13.98  13.50  13.89  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27232  Treat thigh fracture                              A  11.72   8.49NA   8.89NA   8.49     8.89     2.24  22.45  22.85  22.45  22.85  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27235  Treat thigh fracture                              A  13.00  11.13NA  11.68NA  11.13    11.68     2.55  26.68  27.23  26.68  27.23  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27236  Treat thigh fracture                              A  17.61  14.01NA  14.84NA  14.01    14.84     3.46  35.08  35.91  35.08  35.91  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27238  Treat thigh fracture                              A   5.75   6.33NA   6.66NA   6.33     6.66     1.13  13.21  13.54  13.21  13.54  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27240  Treat thigh fracture                              A  13.81  11.46NA  12.05NA  11.46    12.05     2.69  27.96  28.55  27.96  28.55  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27244  Treat thigh fracture                              A  18.18  14.35NA  15.21NA  14.35    15.21     3.56  36.09  36.95  36.09  36.95  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27245  Treat thigh fracture                              A  18.18  14.74NA  15.24NA  14.74    15.24     3.56  36.48  36.98  36.48  36.98  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27246  Treat thigh fracture                              A   4.83   5.33     5.60     5.37     5.65     0.92  11.08  11.35  11.12  11.40  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27248  Treat thigh fracture                              A  10.78   9.01NA   9.34NA   9.01     9.34     2.12  21.91  22.24  21.91  22.24  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27250  Treat hip dislocation                             A   3.82   1.54NA   0.98NA   1.54     0.98     0.67   6.03   5.47   6.03   5.47  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
27252  Treat hip dislocation                             A  11.03   8.92NA   9.37NA   8.92     9.37     2.13  22.08  22.53  22.08  22.53  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27253  Treat hip dislocation                             A  13.58  11.39NA  11.92NA  11.39    11.92     2.66  27.63  28.16  27.63  28.16  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27254  Treat hip dislocation                             A  18.94  14.58NA  15.32NA  14.58    15.32     3.72  37.24  37.98  37.24  37.98  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27256  Treat hip dislocation                             A   4.28   3.43     3.54     1.86     1.79     0.75   8.46   8.57   6.89   6.82  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
27257  Treat hip dislocation                             A   5.38   3.41NA   3.59NA   3.41     3.59     0.98   9.77   9.95   9.77   9.95  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
27258  Treat hip dislocation                             A  16.18  13.17NA  13.92NA  13.17    13.92     3.19  32.54  33.29  32.54  33.29  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27259  Treat hip dislocation                             A  23.26  17.80NA  18.86NA  17.80    18.86     4.56  45.62  46.68  45.62  46.68  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27265  Treat hip dislocation                             A   5.24   5.16NA   5.31NA   5.16     5.31     0.92  11.32  11.47  11.32  11.47  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27266  Treat hip dislocation                             A   7.78   7.59NA   7.99NA   7.59     7.99     1.52  16.89  17.29  16.89  17.29  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27267  Cltx thigh fx                                     A   5.50   5.77NA   6.26NA   5.77     6.26     1.09  12.36  12.85  12.36  12.85  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27268  Cltx thigh fx w/mnpj                              A   7.12   6.78NA   7.47NA   6.78     7.47     1.40  15.30  15.99  15.30  15.99  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27269  Optx thigh fx                                     A  18.89  13.39NA  14.59NA  13.39    14.59     3.69  35.97  37.17  35.97  37.17  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27275  Manipulation of hip joint                         A   2.32   2.45NA   2.54NA   2.45     2.54     0.39   5.16   5.25   5.16   5.25  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
27280  Fusion of sacroiliac joint                        A  14.64  12.48NA  13.11NA  12.48    13.11     3.03  30.15  30.78  30.15  30.78  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27282  Fusion of pubic bones                             A  11.85  10.15NA  11.33NA  10.15    11.33     2.31  24.31  25.49  24.31  25.49  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27284  Fusion of hip joint                               A  25.06  16.67NA  18.84NA  16.67    18.84     4.94  46.67  48.84  46.67  48.84  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27286  Fusion of hip joint                               A  25.17  18.72NA  19.67NA  18.72    19.67     4.96  48.85  49.80  48.85  49.80  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27290  Amputation of leg at hip                          A  24.55  17.74NA  19.51NA  17.74    19.51     4.83  47.12  48.89  47.12  48.89  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27295  Amputation of leg at hip                          A  19.66  13.70NA  14.48NA  13.70    14.48     4.01  37.37  38.15  37.37  38.15  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27299  Pelvis/hip joint surgery                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021211             25.5217 090 99      0.00   0.00   0.00
27301  Drain thigh/knee lesion                           A   6.78  11.08    11.42     6.38     6.74     1.37  19.23  19.57  14.53  14.89  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27303  Drainage of bone lesion                           A   8.63   8.28NA   8.69NA   8.28     8.69     1.68  18.59  19.00  18.59  19.00  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27305  Incise thigh tendon & fascia                      A   6.18   6.36NA   6.80NA   6.36     6.80     1.22  13.76  14.20  13.76  14.20  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27306  Incision of thigh tendon                          A   4.74   5.22NA   5.37NA   5.22     5.37     0.92  10.88  11.03  10.88  11.03  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27307  Incision of thigh tendons                         A   6.06   6.47NA   6.95NA   6.47     6.95     1.20  13.73  14.21  13.73  14.21  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
27310  Exploration of knee joint                         A  10.00   9.31NA   9.82NA   9.31     9.82     1.96  21.27  21.78  21.27  21.78  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27323  Biopsy thigh soft tissues                         A   2.33   5.08     5.23     2.50     2.60     0.41   7.82   7.97   5.24   5.34  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
27324  Biopsy thigh soft tissues                         A   5.04   5.22NA   5.54NA   5.22     5.54     1.05  11.31  11.63  11.31  11.63  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27325  Neurectomy hamstring                              A   7.20   7.18NA   7.89NA   7.18     7.89     1.41  15.79  16.50  15.79  16.50  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27326  Neurectomy popliteal                              A   6.47   6.80NA   7.46NA   6.80     7.46     1.26  14.53  15.19  14.53  15.19  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27327  Exc thigh/knee les sc < 3 cm                      A   3.96   7.95     8.48     4.47     4.44     0.80  12.71  13.24   9.23   9.20  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27328  Exc thigh/knee tum deep <5cm                      A   8.85   6.50NA   7.79NA   6.50     7.79     1.81  17.16  18.45  17.16  18.45  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27329  Resect thigh/knee tum < 5 cm                      A  15.72  11.60NA  12.32NA  11.60    12.32     3.18  30.50  31.22  30.50  31.22  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27330  Biopsy knee joint lining                          A   5.11   5.70NA   6.13NA   5.70     6.13     0.95  11.76  12.19  11.76  12.19  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27331  Explore/treat knee joint                          A   6.02   6.56NA   6.88NA   6.56     6.88     1.18  13.76  14.08  13.76  14.08  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27332  Removal of knee cartilage                         A   8.46   8.49NA   8.91NA   8.49     8.91     1.64  18.59  19.01  18.59  19.01  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27333  Removal of knee cartilage                         A   7.55   7.90NA   8.32NA   7.90     8.32     1.49  16.94  17.36  16.94  17.36  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27334  Remove knee joint lining                          A   9.19   8.85NA   9.34NA   8.85     9.34     1.81  19.85  20.34  19.85  20.34  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27335  Remove knee joint lining                          A  10.55   9.67NA  10.12NA   9.67    10.12     2.06  22.28  22.73  22.28  22.73  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27337  Exc thigh/knee les sc 3+ cm                       A   5.91   5.40NA   5.40NA   5.40     5.40     1.21  12.52  12.52  12.52  12.52  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27339  Exc thigh/knee tum deep 5+cm                      A  11.13   9.13NA   9.13NA   9.13     9.13     2.25  22.51  22.51  22.51  22.51  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27340  Removal of kneecap bursa                          A   4.32   5.49NA   5.79NA   5.49     5.79     0.84  10.65  10.95  10.65  10.95  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27345  Removal of knee cyst                              A   6.09   6.65NA   6.94NA   6.65     6.94     1.20  13.94  14.23  13.94  14.23  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27347  Remove knee cyst                                  A   6.73   7.15NA   7.60NA   7.15     7.60     1.32  15.20  15.65  15.20  15.65  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27350  Removal of kneecap                                A   8.66   8.59NA   9.01NA   8.59     9.01     1.68  18.93  19.35  18.93  19.35  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27355  Remove femur lesion                               A   8.00   7.96NA   8.31NA   7.96     8.31     1.58  17.54  17.89  17.54  17.89  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27356  Remove femur lesion/graft                         A  10.09   9.40NA   9.85NA   9.40     9.85     1.97  21.46  21.91  21.46  21.91  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27357  Remove femur lesion/graft                         A  11.16  10.38NA  10.90NA  10.38    10.90     2.20  23.74  24.26  23.74  24.26  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27358  Remove femur lesion/fixation                      A   4.73   2.73NA   2.83NA   2.73     2.83     0.91   8.37   8.47   8.37   8.47  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
27360  Partial removal leg bone(s)                       A  11.46  11.09NA  11.60NA  11.09    11.60     2.25  24.80  25.31  24.80  25.31  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27364  Resect thigh/knee tum 5+ cm                       A  24.49  17.30NA  17.30NA  17.30    17.30     4.96  46.75  46.75  46.75  46.75  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27365  Resect femur/knee tumor                           A  32.21  18.80NA  23.83NA  18.80    23.83     6.34  57.35  62.38  57.35  62.38  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27370  Injection for knee x-ray                          A   0.96   3.85     3.85     0.48     0.51     0.12   4.93   4.93   1.56   1.59  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
27372  Removal of foreign body                           A   5.21  11.10    11.41     5.53     5.79     1.03  17.34  17.65  11.77  12.03  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27380  Repair of kneecap tendon                          A   7.45   8.28NA   8.61NA   8.28     8.61     1.47  17.20  17.53  17.20  17.53  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27381  Repair/graft kneecap tendon                       A  10.76  10.42NA  10.84NA  10.42    10.84     2.12  23.30  23.72  23.30  23.72  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27385  Repair of thigh muscle                            A   8.11   8.68NA   9.04NA   8.68     9.04     1.59  18.38  18.74  18.38  18.74  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27386  Repair/graft of thigh muscle                      A  11.13  10.91NA  11.38NA  10.91    11.38     2.19  24.23  24.70  24.23  24.70  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27390  Incision of thigh tendon                          A   5.53   6.27NA   6.63NA   6.27     6.63     1.09  12.89  13.25  12.89  13.25  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
27391  Incision of thigh tendons                         A   7.49   7.72NA   8.13NA   7.72     8.13     1.48  16.69  17.10  16.69  17.10  0090.10.69.2120010             25.5217 090 99      0.00   0.00   0.00
27392  Incision of thigh tendons                         A   9.63   9.07NA   9.67NA   9.07     9.67     1.89  20.59  21.19  20.59  21.19  0090.10.69.2122210             25.5217 090 99      0.00   0.00   0.00
27393  Lengthening of thigh tendon                       A   6.59   6.81NA   7.09NA   6.81     7.09     1.29  14.69  14.97  14.69  14.97  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27394  Lengthening of thigh tendons                      A   8.79   8.42NA   8.77NA   8.42     8.77     1.70  18.91  19.26  18.91  19.26  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
27395  Lengthening of thigh tendons                      A  12.24  11.01NA  11.56NA  11.01    11.56     2.40  25.65  26.20  25.65  26.20  0090.10.69.2122210             25.5217 090 99      0.00   0.00   0.00
27396  Transplant of thigh tendon                        A   8.15   8.14NA   8.53NA   8.14     8.53     1.60  17.89  18.28  17.89  18.28  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27397  Transplants of thigh tendons                      A  12.66  11.49NA  12.18NA  11.49    12.18     2.47  26.62  27.31  26.62  27.31  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
27400  Revise thigh muscles/tendons                      A   9.33   8.99NA   9.49NA   8.99     9.49     1.83  20.15  20.65  20.15  20.65  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27403  Repair of knee cartilage                          A   8.62   8.36NA   8.74NA   8.36     8.74     1.67  18.65  19.03  18.65  19.03  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27405  Repair of knee ligament                           A   9.08   8.83NA   9.25NA   8.83     9.25     1.79  19.70  20.12  19.70  20.12  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27407  Repair of knee ligament                           A  10.85   9.81NA  10.62NA   9.81    10.62     2.13  22.79  23.60  22.79  23.60  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27409  Repair of knee ligaments                          A  13.71  11.82NA  12.44NA  11.82    12.44     2.70  28.23  28.85  28.23  28.85  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27412  Autochondrocyte implant knee                      A  24.74  18.86NA  19.95NA  18.86    19.95     4.88  48.48  49.57  48.48  49.57  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27415  Osteochondral knee allograft                      A  20.00  16.25NA  17.29NA  16.25    17.29     3.92  40.17  41.21  40.17  41.21  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27416  Osteochondral knee autograft                      A  14.16  11.55NA  12.41NA  11.55    12.41     2.78  28.49  29.35  28.49  29.35  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27418  Repair degenerated kneecap                        A  11.60  10.45NA  10.91NA  10.45    10.91     2.25  24.30  24.76  24.30  24.76  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27420  Revision of unstable kneecap                      A  10.26   9.51NA   9.95NA   9.51     9.95     2.00  21.77  22.21  21.77  22.21  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27422  Revision of unstable kneecap                      A  10.21   9.48NA   9.92NA   9.48     9.92     1.98  21.67  22.11  21.67  22.11  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27424  Revision/removal of kneecap                       A  10.24   9.47NA   9.86NA   9.47     9.86     2.00  21.71  22.10  21.71  22.10  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27425  Lat retinacular release open                      A   5.39   6.44NA   6.77NA   6.44     6.77     1.06  12.89  13.22  12.89  13.22  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27427  Reconstruction knee                               A   9.79   9.21NA   9.64NA   9.21     9.64     1.91  20.91  21.34  20.91  21.34  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27428  Reconstruction knee                               A  15.58  13.83NA  14.59NA  13.83    14.59     3.08  32.49  33.25  32.49  33.25  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27429  Reconstruction knee                               A  17.54  15.34NA  16.13NA  15.34    16.13     3.46  36.34  37.13  36.34  37.13  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27430  Revision of thigh muscles                         A  10.16   9.43NA   9.88NA   9.43     9.88     1.98  21.57  22.02  21.57  22.02  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27435  Incision of knee joint                            A  10.88  10.40NA  10.96NA  10.40    10.96     2.15  23.43  23.99  23.43  23.99  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27437  Revise kneecap                                    A   8.93   8.55NA   8.98NA   8.55     8.98     1.77  19.25  19.68  19.25  19.68  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27438  Revise kneecap with implant                       A  11.89  10.35NA  10.88NA  10.35    10.88     2.32  24.56  25.09  24.56  25.09  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27440  Revision of knee joint                            A  11.09   9.61NA  10.53NA   9.61    10.53     2.17  22.87  23.79  22.87  23.79  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27441  Revision of knee joint                            A  11.54   9.82NA  10.80NA   9.82    10.80     2.25  23.61  24.59  23.61  24.59  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27442  Revision of knee joint                            A  12.37  10.62NA  11.19NA  10.62    11.19     2.42  25.41  25.98  25.41  25.98  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27443  Revision of knee joint                            A  11.41  10.19NA  10.72NA  10.19    10.72     2.24  23.84  24.37  23.84  24.37  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27445  Revision of knee joint                            A  18.66  14.55NA  15.25NA  14.55    15.25     3.69  36.90  37.60  36.90  37.60  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27446  Revision of knee joint                            A  16.38  12.98NA  13.54NA  12.98    13.54     3.22  32.58  33.14  32.58  33.14  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27447  Total knee arthroplasty                           A  23.25  17.56NA  18.45NA  17.56    18.45     4.56  45.37  46.26  45.37  46.26  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27448  Incision of thigh                                 A  11.60  10.07NA  10.55NA  10.07    10.55     2.28  23.95  24.43  23.95  24.43  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27450  Incision of thigh                                 A  14.61  12.28NA  12.81NA  12.28    12.81     2.89  29.78  30.31  29.78  30.31  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27454  Realignment of thigh bone                         A  19.17  15.00NA  16.08NA  15.00    16.08     3.78  37.95  39.03  37.95  39.03  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27455  Realignment of knee                               A  13.36  11.59NA  12.18NA  11.59    12.18     2.62  27.57  28.16  27.57  28.16  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27457  Realignment of knee                               A  14.03  11.51NA  12.05NA  11.51    12.05     2.76  28.30  28.84  28.30  28.84  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27465  Shortening of thigh bone                          A  18.60  14.25NA  15.39NA  14.25    15.39     3.68  36.53  37.67  36.53  37.67  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27466  Lengthening of thigh bone                         A  17.28  13.93NA  14.53NA  13.93    14.53     3.41  34.62  35.22  34.62  35.22  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27468  Shorten/lengthen thighs                           A  19.97  15.46NA  16.44NA  15.46    16.44     3.92  39.35  40.33  39.35  40.33  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27470  Repair of thigh                                   A  17.14  14.11NA  14.81NA  14.11    14.81     3.38  34.63  35.33  34.63  35.33  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27472  Repair/graft of thigh                             A  18.72  14.85NA  15.52NA  14.85    15.52     3.69  37.26  37.93  37.26  37.93  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27475  Surgery to stop leg growth                        A   8.93   7.21NA   6.34NA   7.21     6.34     1.77  17.91  17.04  17.91  17.04  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27477  Surgery to stop leg growth                        A  10.14   9.24NA   9.72NA   9.24     9.72     1.98  21.36  21.84  21.36  21.84  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27479  Surgery to stop leg growth                        A  13.16  11.24NA  11.78NA  11.24    11.78     0.92  25.32  25.86  25.32  25.86  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27485  Surgery to stop leg growth                        A   9.13   8.63NA   9.04NA   8.63     9.04     1.81  19.57  19.98  19.57  19.98  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27486  Revise/replace knee joint                         A  21.12  16.23NA  17.04NA  16.23    17.04     4.14  41.49  42.30  41.49  42.30  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27487  Revise/replace knee joint                         A  27.11  19.64NA  20.59NA  19.64    20.59     5.32  52.07  53.02  52.07  53.02  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27488  Removal of knee prosthesis                        A  17.60  14.22NA  14.97NA  14.22    14.97     3.46  35.28  36.03  35.28  36.03  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27495  Reinforce thigh                                   A  16.54  13.39NA  14.02NA  13.39    14.02     3.25  33.18  33.81  33.18  33.81  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27496  Decompression of thigh/knee                       A   6.78   7.15NA   7.96NA   7.15     7.96     1.33  15.26  16.07  15.26  16.07  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27497  Decompression of thigh/knee                       A   7.79   7.12NA   7.98NA   7.12     7.98     1.53  16.44  17.30  16.44  17.30  0090.10.69.2121020             25.5217 090 99      0.00   0.00   0.00
27498  Decompression of thigh/knee                       A   8.66   7.87NA   9.09NA   7.87     9.09     1.68  18.21  19.43  18.21  19.43  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27499  Decompression of thigh/knee                       A   9.43   8.52NA   9.55NA   8.52     9.55     1.86  19.81  20.84  19.81  20.84  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27500  Treatment of thigh fracture                       A   6.30   7.36     7.76     6.30     6.70     1.22  14.88  15.28  13.82  14.22  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27501  Treatment of thigh fracture                       A   6.45   6.87     7.21     6.70     7.09     1.26  14.58  14.92  14.41  14.80  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27502  Treatment of thigh fracture                       A  11.36   9.31NA   9.69NA   9.31     9.69     2.19  22.86  23.24  22.86  23.24  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27503  Treatment of thigh fracture                       A  11.27   9.99NA  10.53NA   9.99    10.53     2.20  23.46  24.00  23.46  24.00  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27506  Treatment of thigh fracture                       A  19.65  15.78NA  16.66NA  15.78    16.66     3.86  39.29  40.17  39.29  40.17  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27507  Treatment of thigh fracture                       A  14.48  11.39NA  11.90NA  11.39    11.90     2.85  28.72  29.23  28.72  29.23  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27508  Treatment of thigh fracture                       A   6.20   7.65     8.02     6.80     7.17     1.20  15.05  15.42  14.20  14.57  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27509  Treatment of thigh fracture                       A   8.14   9.03NA   9.41NA   9.03     9.41     1.59  18.76  19.14  18.76  19.14  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27510  Treatment of thigh fracture                       A   9.80   8.54NA   8.84NA   8.54     8.84     1.87  20.21  20.51  20.21  20.51  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27511  Treatment of thigh fracture                       A  15.11  11.62NA  11.95NA  11.62    11.95     2.97  29.70  30.03  29.70  30.03  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27513  Treatment of thigh fracture                       A  19.25  14.08NA  14.41NA  14.08    14.41     3.79  37.12  37.45  37.12  37.45  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27514  Treatment of thigh fracture                       A  14.60  11.68NA  11.63NA  11.68    11.63     2.87  29.15  29.10  29.15  29.10  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27516  Treat thigh fx growth plate                       A   5.59   7.71     8.22     6.87     7.35     1.10  14.40  14.91  13.56  14.04  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27517  Treat thigh fx growth plate                       A   9.12   8.98NA   9.47NA   8.98     9.47     1.79  19.89  20.38  19.89  20.38  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27519  Treat thigh fx growth plate                       A  13.25  10.81NA  10.91NA  10.81    10.91     2.61  26.67  26.77  26.67  26.77  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27520  Treat kneecap fracture                            A   3.04   5.46     5.73     4.64     4.96     0.58   9.08   9.35   8.26   8.58  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27524  Treat kneecap fracture                            A  10.37   9.59NA  10.04NA   9.59    10.04     2.02  21.98  22.43  21.98  22.43  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27530  Treat knee fracture                               A   4.09   6.43     6.75     5.66     6.00     0.77  11.29  11.61  10.52  10.86  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27532  Treat knee fracture                               A   7.55   8.75     9.20     7.74     8.16     1.48  17.78  18.23  16.77  17.19  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27535  Treat knee fracture                               A  13.41  10.61NA  10.93NA  10.61    10.93     2.62  26.64  26.96  26.64  26.96  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27536  Treat knee fracture                               A  17.39  14.16NA  14.94NA  14.16    14.94     3.42  34.97  35.75  34.97  35.75  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27538  Treat knee fracture(s)                            A   5.09   7.39     7.77     6.55     6.94     0.99  13.47  13.85  12.63  13.02  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27540  Treat knee fracture                               A  11.30  10.40NA  10.76NA  10.40    10.76     2.21  23.91  24.27  23.91  24.27  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27550  Treat knee dislocation                            A   5.98   7.13     7.47     6.14     6.48     1.10  14.21  14.55  13.22  13.56  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27552  Treat knee dislocation                            A   8.18   8.37NA   8.83NA   8.37     8.83     1.60  18.15  18.61  18.15  18.61  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27556  Treat knee dislocation                            A  13.00  10.67NA  10.76NA  10.67    10.76     2.57  26.24  26.33  26.24  26.33  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27557  Treat knee dislocation                            A  15.90  12.36NA  12.50NA  12.36    12.50     3.14  31.40  31.54  31.40  31.54  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27558  Treat knee dislocation                            A  18.39  13.61NA  13.99NA  13.61    13.99     3.61  35.61  35.99  35.61  35.99  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27560  Treat kneecap dislocation                         A   3.99   5.97     6.36     5.12     5.64     0.76  10.72  11.11   9.87  10.39  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27562  Treat kneecap dislocation                         A   5.98   6.55NA   7.13NA   6.55     7.13     1.18  13.71  14.29  13.71  14.29  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27566  Treat kneecap dislocation                         A  12.71  10.90NA  11.40NA  10.90    11.40     2.50  26.11  26.61  26.11  26.61  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27570  Fixation of knee joint                            A   1.79   2.19NA   2.31NA   2.19     2.31     0.34   4.32   4.44   4.32   4.44  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
27580  Fusion of knee                                    A  21.10  17.11NA  17.90NA  17.11    17.90     4.14  42.35  43.14  42.35  43.14  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27590  Amputate leg at thigh                             A  13.47   8.11NA   8.44NA   8.11     8.44     2.95  24.53  24.86  24.53  24.86  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27591  Amputate leg at thigh                             A  13.94   9.95NA  10.17NA   9.95    10.17     2.91  26.80  27.02  26.80  27.02  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27592  Amputate leg at thigh                             A  10.98   7.51NA   7.82NA   7.51     7.82     2.34  20.83  21.14  20.83  21.14  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27594  Amputation follow-up surgery                      A   7.29   6.26NA   6.45NA   6.26     6.45     1.55  15.10  15.29  15.10  15.29  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27596  Amputation follow-up surgery                      A  11.29   8.07NA   8.37NA   8.07     8.37     2.39  21.75  22.05  21.75  22.05  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27598  Amputate lower leg at knee                        A  11.22   8.51NA   8.85NA   8.51     8.85     2.32  22.05  22.39  22.05  22.39  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27599  Leg surgery procedure                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021211             25.5217 090 99      0.00   0.00   0.00
27600  Decompression of lower leg                        A   6.03   5.09NA   5.14NA   5.09     5.14     1.26  12.38  12.43  12.38  12.43  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27601  Decompression of lower leg                        A   6.05   5.79NA   6.00NA   5.79     6.00     1.26  13.10  13.31  13.10  13.31  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27602  Decompression of lower leg                        A   7.82   5.65NA   5.68NA   5.65     5.68     1.74  15.21  15.24  15.21  15.24  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27603  Drain lower leg lesion                            A   5.23   9.21     9.64     5.23     5.54     1.00  15.44  15.87  11.46  11.77  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27604  Drain lower leg bursa                             A   4.59   8.14     8.63     4.50     4.70     0.77  13.50  13.99   9.86  10.06  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27605  Incision of achilles tendon                       A   2.92   6.81     6.55     2.27     2.20     0.34  10.07   9.81   5.53   5.46  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
27606  Incision of achilles tendon                       A   4.18   3.59NA   3.68NA   3.59     3.68     0.72   8.49   8.58   8.49   8.58  0010.10.80.1021110             25.5217 090 99      0.00   0.00   0.00
27607  Treat lower leg bone lesion                       A   8.62   7.75NA   8.14NA   7.75     8.14     1.58  17.95  18.34  17.95  18.34  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27610  Explore/treat ankle joint                         A   9.13   8.35NA   8.75NA   8.35     8.75     1.63  19.11  19.51  19.11  19.51  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27612  Exploration of ankle joint                        A   8.15   7.10NA   7.37NA   7.10     7.37     1.15  16.40  16.67  16.40  16.67  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27613  Biopsy lower leg soft tissue                      A   2.22   4.77     4.92     2.31     2.39     0.31   7.30   7.45   4.84   4.92  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
27614  Biopsy lower leg soft tissue                      A   5.80   9.66    10.13     5.14     5.30     1.03  16.49  16.96  11.97  12.13  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27615  Resect leg/ankle tum < 5 cm                       A  15.72  11.03NA  12.26NA  11.03    12.26     3.14  29.89  31.12  29.89  31.12  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
27616  Resect leg/ankle tum 5+ cm                        A  19.63  14.66NA  14.66NA  14.66    14.66     3.90  38.19  38.19  38.19  38.19  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
27618  Exc leg/ankle tum < 3 cm                          A   3.96   8.07     8.36     4.59     4.39     0.73  12.76  13.05   9.28   9.08  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27619  Exc leg/ankle tum deep <5 cm                      A   6.91   6.52NA   6.34NA   6.52     6.34     1.22  14.65  14.47  14.65  14.47  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27620  Explore/treat ankle joint                         A   6.15   6.21NA   6.44NA   6.21     6.44     1.05  13.41  13.64  13.41  13.64  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27625  Remove ankle joint lining                         A   8.49   7.18NA   7.34NA   7.18     7.34     1.26  16.93  17.09  16.93  17.09  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27626  Remove ankle joint lining                         A   9.10   7.85NA   8.13NA   7.85     8.13     1.52  18.47  18.75  18.47  18.75  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27630  Removal of tendon lesion                          A   4.94  10.09    10.64     5.01     5.18     0.77  15.80  16.35  10.72  10.89  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27632  Exc leg/ankle les sc 3+ cm                        A   5.91   5.36NA   5.36NA   5.36     5.36     1.13  12.40  12.40  12.40  12.40  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27634  Exc leg/ankle tum deep 5+ cm                      A  10.13   8.16NA   8.16NA   8.16     8.16     1.79  20.08  20.08  20.08  20.08  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27635  Remove lower leg bone lesion                      A   8.03   7.81NA   8.16NA   7.81     8.16     1.49  17.33  17.68  17.33  17.68  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27637  Remove/graft leg bone lesion                      A  10.31   9.86NA  10.41NA   9.86    10.41     2.01  22.18  22.73  22.18  22.73  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27638  Remove/graft leg bone lesion                      A  10.99   9.59NA   9.93NA   9.59     9.93     2.16  22.74  23.08  22.74  23.08  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27640  Partial removal of tibia                          A  12.24  10.52NA  10.74NA  10.52    10.74     2.20  24.96  25.18  24.96  25.18  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27641  Partial removal of fibula                         A   9.84   8.37NA   8.49NA   8.37     8.49     1.67  19.88  20.00  19.88  20.00  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27645  Resect tibia tumor                                A  27.21  16.76NA  21.11NA  16.76    21.11     5.35  49.32  53.67  49.32  53.67  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27646  Resect fibula tumor                               A  23.21  14.80NA  18.71NA  14.80    18.71     4.56  42.57  46.48  42.57  46.48  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27647  Resect talus/calcaneus tum                        A  20.26   9.53NA  10.89NA   9.53    10.89     2.02  31.81  33.17  31.81  33.17  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27648  Injection for ankle x-ray                         A   0.96   3.65     3.63     0.46     0.49     0.12   4.73   4.71   1.54   1.57  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
27650  Repair achilles tendon                            A   9.21   8.84NA   9.18NA   8.84     9.18     1.51  19.56  19.90  19.56  19.90  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27652  Repair/graft achilles tendon                      A  10.78   8.54NA   8.61NA   8.54     8.61     1.51  20.83  20.90  20.83  20.90  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27654  Repair of achilles tendon                         A  10.53   8.81NA   9.18NA   8.81     9.18     1.51  20.85  21.22  20.85  21.22  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27656  Repair leg fascia defect                          A   4.71  11.33    12.67     5.31     6.06     0.91  16.95  18.29  10.93  11.68  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27658  Repair of leg tendon each                         A   5.12   5.15NA   5.30NA   5.15     5.30     0.77  11.04  11.19  11.04  11.19  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27659  Repair of leg tendon each                         A   7.10   6.25NA   6.45NA   6.25     6.45     0.99  14.34  14.54  14.34  14.54  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27664  Repair of leg tendon each                         A   4.73   5.17NA   5.39NA   5.17     5.39     0.75  10.65  10.87  10.65  10.87  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
27665  Repair of leg tendon each                         A   5.57   5.60NA   5.73NA   5.60     5.73     0.88  12.05  12.18  12.05  12.18  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27675  Repair lower leg tendons                          A   7.35   6.11NA   6.18NA   6.11     6.18     1.02  14.48  14.55  14.48  14.55  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27676  Repair lower leg tendons                          A   8.73   7.83NA   8.13NA   7.83     8.13     1.70  18.26  18.56  18.26  18.56  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27680  Release of lower leg tendon                       A   5.88   5.80NA   6.07NA   5.80     6.07     0.98  12.66  12.93  12.66  12.93  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
27681  Release of lower leg tendons                      A   7.05   7.14NA   7.77NA   7.14     7.77     1.39  15.58  16.21  15.58  16.21  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
27685  Revision of lower leg tendon                      A   6.69  11.06    11.87     6.09     6.25     0.91  18.66  19.47  13.69  13.85  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
27686  Revise lower leg tendons                          A   7.75   7.26NA   7.49NA   7.26     7.49     1.29  16.30  16.53  16.30  16.53  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
27687  Revision of calf tendon                           A   6.41   6.00NA   6.22NA   6.00     6.22     0.99  13.40  13.62  13.40  13.62  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27690  Revise lower leg tendon                           A   9.17   8.11NA   8.56NA   8.11     8.56     1.32  18.60  19.05  18.60  19.05  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27691  Revise lower leg tendon                           A  10.49   9.70NA  10.19NA   9.70    10.19     1.82  22.01  22.50  22.01  22.50  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27692  Revise additional leg tendon                      A   1.87   1.01NA   1.06NA   1.01     1.06     0.34   3.22   3.27   3.22   3.27  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
27695  Repair of ankle ligament                          A   6.70   6.42NA   6.51NA   6.42     6.51     1.07  14.19  14.28  14.19  14.28  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27696  Repair of ankle ligaments                         A   8.58   6.91NA   7.03NA   6.91     7.03     1.15  16.64  16.76  16.64  16.76  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27698  Repair of ankle ligament                          A   9.61   7.87NA   8.12NA   7.87     8.12     1.51  18.99  19.24  18.99  19.24  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27700  Revision of ankle joint                           A   9.66   6.70NA   6.81NA   6.70     6.81     1.20  17.56  17.67  17.56  17.67  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27702  Reconstruct ankle joint                           A  14.42  11.82NA  12.18NA  11.82    12.18     2.65  28.89  29.25  28.89  29.25  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27703  Reconstruction ankle joint                        A  16.94  13.35NA  13.78NA  13.35    13.78     3.18  33.47  33.90  33.47  33.90  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27704  Removal of ankle implant                          A   7.81   7.52NA   8.00NA   7.52     8.00     1.41  16.74  17.22  16.74  17.22  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27705  Incision of tibia                                 A  10.86   9.51NA   9.95NA   9.51     9.95     2.01  22.38  22.82  22.38  22.82  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27707  Incision of fibula                                A   4.78   6.03NA   6.36NA   6.03     6.36     0.90  11.71  12.04  11.71  12.04  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27709  Incision of tibia & fibula                        A  17.48  13.32NA  14.66NA  13.32    14.66     3.37  34.17  35.51  34.17  35.51  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27712  Realignment of lower leg                          A  15.87  13.35NA  14.11NA  13.35    14.11     3.14  32.36  33.12  32.36  33.12  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27715  Revision of lower leg                             A  15.50  12.59NA  13.03NA  12.59    13.03     3.07  31.16  31.60  31.16  31.60  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27720  Repair of tibia                                   A  12.36  10.95NA  11.42NA  10.95    11.42     2.39  25.70  26.17  25.70  26.17  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27722  Repair/graft of tibia                             A  12.45  11.00NA  11.69NA  11.00    11.69     2.43  25.88  26.57  25.88  26.57  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27724  Repair/graft of tibia                             A  19.31  14.45NA  15.12NA  14.45    15.12     3.79  37.55  38.22  37.55  38.22  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27725  Repair of lower leg                               A  17.41  14.78NA  15.70NA  14.78    15.70     3.44  35.63  36.55  35.63  36.55  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27726  Repair fibula nonunion                            A  14.34  10.92NA  12.13NA  10.92    12.13     2.77  28.03  29.24  28.03  29.24  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27727  Repair of lower leg                               A  14.84  11.71NA  13.27NA  11.71    13.27     2.93  29.48  31.04  29.48  31.04  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27730  Repair of tibia epiphysis                         A   7.70   7.77NA   8.19NA   7.77     8.19     1.52  16.99  17.41  16.99  17.41  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27732  Repair of fibula epiphysis                        A   5.46   5.88NA   6.68NA   5.88     6.68     1.07  12.41  13.21  12.41  13.21  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27734  Repair lower leg epiphyses                        A   8.83   7.79NA   8.94NA   7.79     8.94     0.62  17.24  18.39  17.24  18.39  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27740  Repair of leg epiphyses                           A   9.61   7.11NA   6.76NA   7.11     6.76     1.89  18.61  18.26  18.61  18.26  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27742  Repair of leg epiphyses                           A  10.63   8.11NA   9.01NA   8.11     9.01     2.08  20.82  21.72  20.82  21.72  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27745  Reinforce tibia                                   A  10.49   9.53NA   9.93NA   9.53     9.93     2.04  22.06  22.46  22.06  22.46  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27750  Treatment of tibia fracture                       A   3.37   5.74     6.03     4.95     5.25     0.64   9.75  10.04   8.96   9.26  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27752  Treatment of tibia fracture                       A   6.27   7.99     8.38     6.89     7.25     1.21  15.47  15.86  14.37  14.73  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27756  Treatment of tibia fracture                       A   7.45   7.77NA   8.15NA   7.77     8.15     1.45  16.67  17.05  16.67  17.05  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27758  Treatment of tibia fracture                       A  12.54  11.08NA  11.66NA  11.08    11.66     2.44  26.06  26.64  26.06  26.64  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27759  Treatment of tibia fracture                       A  14.45  12.08NA  12.65NA  12.08    12.65     2.84  29.37  29.94  29.37  29.94  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27760  Cltx medial ankle fx                              A   3.21   5.63     5.89     4.79     5.09     0.58   9.42   9.68   8.58   8.88  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27762  Cltx med ankle fx w/mnpj                          A   5.47   7.33     7.60     6.23     6.47     1.00  13.80  14.07  12.70  12.94  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27766  Optx medial ankle fx                              A   7.89   8.38NA   8.77NA   8.38     8.77     1.51  17.78  18.17  17.78  18.17  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27767  Cltx post ankle fx                                A   2.64   4.67     5.07     4.71     5.12     0.50   7.81   8.21   7.85   8.26  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27768  Cltx post ankle fx w/mnpj                         A   5.14   6.13NA   6.81NA   6.13     6.81     1.02  12.29  12.97  12.29  12.97  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27769  Optx post ankle fx                                A  10.14   8.84NA   9.85NA   8.84     9.85     1.98  20.96  21.97  20.96  21.97  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27780  Treatment of fibula fracture                      A   2.83   5.17     5.47     4.40     4.72     0.53   8.53   8.83   7.76   8.08  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27781  Treatment of fibula fracture                      A   4.59   6.64     6.98     5.80     6.13     0.87  12.10  12.44  11.26  11.59  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27784  Treatment of fibula fracture                      A   9.67   9.19NA   9.88NA   9.19     9.88     1.87  20.73  21.42  20.73  21.42  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27786  Treatment of ankle fracture                       A   3.02   5.36     5.61     4.49     4.79     0.54   8.92   9.17   8.05   8.35  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27788  Treatment of ankle fracture                       A   4.64   6.61     6.89     5.63     5.90     0.84  12.09  12.37  11.11  11.38  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27792  Treatment of ankle fracture                       A   9.71   9.19NA   9.79NA   9.19     9.79     1.83  20.73  21.33  20.73  21.33  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27808  Treatment of ankle fracture                       A   3.03   5.79     6.07     4.85     5.14     0.56   9.38   9.66   8.44   8.73  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27810  Treatment of ankle fracture                       A   5.32   7.19     7.44     6.06     6.29     1.00  13.51  13.76  12.38  12.61  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27814  Treatment of ankle fracture                       A  10.62   9.98NA  10.44NA   9.98    10.44     2.04  22.64  23.10  22.64  23.10  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27816  Treatment of ankle fracture                       A   3.07   5.30     5.62     4.41     4.72     0.54   8.91   9.23   8.02   8.33  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27818  Treatment of ankle fracture                       A   5.69   7.12     7.33     5.84     6.02     1.05  13.86  14.07  12.58  12.76  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27822  Treatment of ankle fracture                       A  11.21  11.40NA  11.75NA  11.40    11.75     2.16  24.77  25.12  24.77  25.12  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27823  Treatment of ankle fracture                       A  13.16  12.47NA  12.91NA  12.47    12.91     2.54  28.17  28.61  28.17  28.61  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27824  Treat lower leg fracture                          A   3.31   4.95     5.20     4.66     4.95     0.61   8.87   9.12   8.58   8.87  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27825  Treat lower leg fracture                          A   6.69   7.83     8.17     6.48     6.77     1.28  15.80  16.14  14.45  14.74  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27826  Treat lower leg fracture                          A  11.10  11.13NA  11.77NA  11.13    11.77     2.13  24.36  25.00  24.36  25.00  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27827  Treat lower leg fracture                          A  14.79  14.17NA  14.74NA  14.17    14.74     2.89  31.85  32.42  31.85  32.42  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27828  Treat lower leg fracture                          A  18.43  16.12NA  16.87NA  16.12    16.87     3.59  38.14  38.89  38.14  38.89  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27829  Treat lower leg joint                             A   8.80   9.28NA   9.88NA   9.28     9.88     1.68  19.76  20.36  19.76  20.36  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
27830  Treat lower leg dislocation                       A   3.96   5.85     6.40     5.16     5.67     0.76  10.57  11.12   9.88  10.39  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27831  Treat lower leg dislocation                       A   4.73   5.65NA   6.13NA   5.65     6.13     0.91  11.29  11.77  11.29  11.77  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27832  Treat lower leg dislocation                       A  10.17   9.41NA  10.35NA   9.41    10.35     1.98  21.56  22.50  21.56  22.50  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27840  Treat ankle dislocation                           A   4.77   4.70NA   4.96NA   4.70     4.96     0.83  10.30  10.56  10.30  10.56  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27842  Treat ankle dislocation                           A   6.46   6.61NA   7.07NA   6.61     7.07     1.21  14.28  14.74  14.28  14.74  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27846  Treat ankle dislocation                           A  10.28   9.30NA   9.67NA   9.30     9.67     1.94  21.52  21.89  21.52  21.89  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27848  Treat ankle dislocation                           A  11.68  10.28NA  10.54NA  10.28    10.54     2.24  24.20  24.46  24.20  24.46  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27860  Fixation of ankle joint                           A   2.39   2.33NA   2.37NA   2.33     2.37     0.39   5.11   5.15   5.11   5.15  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
27870  Fusion of ankle joint open                        A  15.41  12.45NA  12.97NA  12.45    12.97     2.80  30.66  31.18  30.66  31.18  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27871  Fusion of tibiofibular joint                      A   9.54   8.90NA   9.30NA   8.90     9.30     1.85  20.29  20.69  20.29  20.69  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27880  Amputation of lower leg                           A  15.37   9.07NA   9.54NA   9.07     9.54     3.31  27.75  28.22  27.75  28.22  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27881  Amputation of lower leg                           A  13.47  10.01NA  10.28NA  10.01    10.28     2.80  26.28  26.55  26.28  26.55  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27882  Amputation of lower leg                           A   9.79   6.66NA   6.71NA   6.66     6.71     2.15  18.60  18.65  18.60  18.65  0090.10.69.2121010             25.5217 090 99      0.00   0.00   0.00
27884  Amputation follow-up surgery                      A   8.76   6.80NA   7.03NA   6.80     7.03     1.86  17.42  17.65  17.42  17.65  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
27886  Amputation follow-up surgery                      A  10.02   7.69NA   7.93NA   7.69     7.93     2.13  19.84  20.08  19.84  20.08  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27888  Amputation of foot at ankle                       A  10.37   8.15NA   8.18NA   8.15     8.18     1.93  20.45  20.48  20.45  20.48  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
27889  Amputation of foot at ankle                       A  10.86   7.05NA   7.07NA   7.05     7.07     2.40  20.31  20.33  20.31  20.33  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
27892  Decompression of leg                              A   7.94   6.67NA   7.03NA   6.67     7.03     1.63  16.24  16.60  16.24  16.60  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27893  Decompression of leg                              A   7.90   7.62NA   8.63NA   7.62     8.63     1.67  17.19  18.20  17.19  18.20  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
27894  Decompression of leg                              A  12.67  10.01NA  10.48NA  10.01    10.48     2.66  25.34  25.81  25.34  25.81  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
27899  Leg/ankle surgery procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
28001  Drainage of bursa of foot                         A   2.78   4.75     5.00     2.02     1.98     0.23   7.76   8.01   5.03   4.99  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
28002  Treatment of foot infection                       A   5.93   8.08     8.56     4.52     4.59     0.67  14.68  15.16  11.12  11.19  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
28003  Treatment of foot infection                       A   9.06   9.42     9.83     5.81     5.77     1.06  19.54  19.95  15.93  15.89  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28005  Treat foot bone lesion                            A   9.44   7.06NA   7.14NA   7.06     7.14     1.02  17.52  17.60  17.52  17.60  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28008  Incision of foot fascia                           A   4.59   7.27     7.65     3.68     3.68     0.41  12.27  12.65   8.68   8.68  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28010  Incision of toe tendon                            A   2.97   3.48     3.65     2.92     2.99     0.27   6.72   6.89   6.16   6.23  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28011  Incision of toe tendons                           A   4.28   4.79     5.07     3.93     4.05     0.49   9.56   9.84   8.70   8.82  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28020  Exploration of foot joint                         A   5.15   9.19     9.89     4.70     4.85     0.67  15.01  15.71  10.52  10.67  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28022  Exploration of foot joint                         A   4.81   8.28     8.76     4.20     4.19     0.49  13.58  14.06   9.50   9.49  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28024  Exploration of toe joint                          A   4.52   7.89     8.29     3.99     3.93     0.42  12.83  13.23   8.93   8.87  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28035  Decompression of tibia nerve                      A   5.23   9.00     9.50     4.61     4.65     0.65  14.88  15.38  10.49  10.53  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28039  Exc foot/toe tum sc > 1.5 cm                      A   5.42   8.38     8.38     4.05     4.05     0.54  14.34  14.34  10.01  10.01  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
28041  Exc foot/toe tum deep 1.5cm+                      A   7.13   5.30NA   5.30NA   5.30     5.30     0.73  13.16  13.16  13.16  13.16  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28043  Exc foot/toe tum sc < 1.5 cm                      A   3.96   6.52     7.53     3.49     3.53     0.39  10.87  11.88   7.84   7.88  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28045  Exc foot/toe tum deep <1.5cm                      A   5.45   8.45     8.90     4.32     4.55     0.56  14.46  14.91  10.33  10.56  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28046  Resect foot/toe tumor < 3 cm                      A  12.38   7.94NA   8.56NA   7.94     8.56     1.66  21.98  22.60  21.98  22.60  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28047  Resect foot/toe tumor > 3 cm                      A  17.45   8.56NA   8.56NA   8.56     8.56     1.33  27.34  27.34  27.34  27.34  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28050  Biopsy of foot joint lining                       A   4.39   7.73     7.72     3.83     3.56     0.39  12.51  12.50   8.61   8.34  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28052  Biopsy of foot joint lining                       A   4.06   7.61     8.07     3.67     3.67     0.49  12.16  12.62   8.22   8.22  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28054  Biopsy of toe joint lining                        A   3.57   7.08     7.14     3.32     3.12     0.27  10.92  10.98   7.16   6.96  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28055  Neurectomy foot                                   A   6.29   4.38NA   4.42NA   4.38     4.42     0.53  11.20  11.24  11.20  11.24  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28060  Partial removal foot fascia                       A   5.40   8.65     9.20     4.52     4.60     0.54  14.59  15.14  10.46  10.54  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28062  Removal of foot fascia                            A   6.69   9.52     9.96     4.78     4.82     0.60  16.81  17.25  12.07  12.11  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28070  Removal of foot joint lining                      A   5.24   9.02     9.92     4.57     4.79     0.56  14.82  15.72  10.37  10.59  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28072  Removal of foot joint lining                      A   4.72   9.20     9.81     4.67     4.69     0.64  14.56  15.17  10.03  10.05  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28080  Removal of foot lesion                            A   4.86   9.16     9.87     5.16     5.40     0.48  14.50  15.21  10.50  10.74  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28086  Excise foot tendon sheath                         A   4.92   9.81    10.27     4.93     5.03     0.72  15.45  15.91  10.57  10.67  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28088  Excise foot tendon sheath                         A   3.98   9.04     9.85     4.39     4.58     0.54  13.56  14.37   8.91   9.10  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28090  Removal of foot lesion                            A   4.55   8.21     8.74     4.03     4.10     0.48  13.24  13.77   9.06   9.13  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28092  Removal of toe lesions                            A   3.78   7.86     8.34     3.82     3.86     0.39  12.03  12.51   7.99   8.03  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28100  Removal of ankle/heel lesion                      A   5.83  10.36    10.84     5.31     5.43     0.76  16.95  17.43  11.90  12.02  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28102  Remove/graft foot lesion                          A   7.92   7.81NA   8.53NA   7.81     8.53     0.61  16.34  17.06  16.34  17.06  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
28103  Remove/graft foot lesion                          A   6.67   4.92NA   4.46NA   4.92     4.46     0.50  12.09  11.63  12.09  11.63  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
28104  Removal of foot lesion                            A   5.26   8.70     9.23     4.38     4.41     0.54  14.50  15.03  10.18  10.21  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28106  Remove/graft foot lesion                          A   7.35   5.07NA   4.83NA   5.07     4.83     0.56  12.98  12.74  12.98  12.74  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28107  Remove/graft foot lesion                          A   5.73   9.11     9.00     4.48     4.18     0.42  15.26  15.15  10.63  10.33  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
28108  Removal of toe lesions                            A   4.30   7.61     8.12     3.75     3.80     0.38  12.29  12.80   8.43   8.48  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28110  Part removal of metatarsal                        A   4.22   8.34     8.87     3.84     3.90     0.41  12.97  13.50   8.47   8.53  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28111  Part removal of metatarsal                        A   5.15   8.82     9.22     4.15     4.20     0.60  14.57  14.97   9.90   9.95  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28112  Part removal of metatarsal                        A   4.63   8.81     9.33     4.15     4.22     0.52  13.96  14.48   9.30   9.37  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28113  Part removal of metatarsal                        A   6.11  10.12    10.80     5.75     5.96     0.62  16.85  17.53  12.48  12.69  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28114  Removal of metatarsal heads                       A  12.00  16.92    18.04    10.78    11.29     1.64  30.56  31.68  24.42  24.93  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28116  Revision of foot                                  A   9.14  11.36    12.22     6.64     6.89     0.95  21.45  22.31  16.73  16.98  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28118  Removal of heel bone                              A   6.13   9.85    10.48     5.23     5.35     0.75  16.73  17.36  12.11  12.23  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28119  Removal of heel spur                              A   5.56   8.72     9.29     4.49     4.58     0.53  14.81  15.38  10.58  10.67  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28120  Part removal of ankle/heel                        A   8.27  10.84    12.11     6.00     6.97     1.14  20.25  21.52  15.41  16.38  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28122  Partial removal of foot bone                      A   7.72  10.25    10.72     6.09     6.16     0.81  18.78  19.25  14.62  14.69  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28124  Partial removal of toe                            A   5.00   8.10     8.57     4.31     4.34     0.42  13.52  13.99   9.73   9.76  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28126  Partial removal of toe                            A   3.64   7.12     7.58     3.35     3.36     0.34  11.10  11.56   7.33   7.34  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28130  Removal of ankle bone                             A   9.50   8.95NA  10.29NA   8.95    10.29     1.86  20.31  21.65  20.31  21.65  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28140  Removal of metatarsal                             A   7.14   9.60     9.89     5.25     5.24     0.90  17.64  17.93  13.29  13.28  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28150  Removal of toe                                    A   4.23   7.66     8.12     3.76     3.80     0.42  12.31  12.77   8.41   8.45  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28153  Partial removal of toe                            A   3.80   7.45     7.99     3.58     3.70     0.37  11.62  12.16   7.75   7.87  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28160  Partial removal of toe                            A   3.88   7.62     8.14     3.73     3.76     0.38  11.88  12.40   7.99   8.02  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28171  Resect tarsal tumor                               A  16.41   7.08NA   7.71NA   7.08     7.71     1.25  24.74  25.37  24.74  25.37  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
28173  Resect metatarsal tumor                           A  14.16   6.68NA   7.48NA   6.68     7.48     1.56  22.40  23.20  22.40  23.20  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28175  Resect phalanx of toe tumor                       A   8.29   5.02NA   5.58NA   5.02     5.58     0.80  14.11  14.67  14.11  14.67  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28190  Removal of foot foreign body                      A   2.01   4.94     5.22     1.72     1.76     0.20   7.15   7.43   3.93   3.97  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
28192  Removal of foot foreign body                      A   4.78   8.16     8.62     4.05     4.10     0.49  13.43  13.89   9.32   9.37  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28193  Removal of foot foreign body                      A   5.90   8.76     9.22     4.52     4.55     0.56  15.22  15.68  10.98  11.01  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28200  Repair of foot tendon                             A   4.74   8.28     8.80     4.07     4.11     0.45  13.47  13.99   9.26   9.30  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28202  Repair/graft of foot tendon                       A   7.07   9.38     9.52     4.87     4.75     0.64  17.09  17.23  12.58  12.46  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28208  Repair of foot tendon                             A   4.51   8.15     8.76     4.05     4.17     0.49  13.15  13.76   9.05   9.17  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28210  Repair/graft of foot tendon                       A   6.52   9.20     9.64     4.88     4.93     0.64  16.36  16.80  12.04  12.09  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
28220  Release of foot tendon                            A   4.67   7.63     8.08     3.84     3.84     0.41  12.71  13.16   8.92   8.92  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28222  Release of foot tendons                           A   5.76   8.29     8.78     4.24     4.19     0.50  14.55  15.04  10.50  10.45  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28225  Release of foot tendon                            A   3.78   7.09     7.57     3.35     3.39     0.35  11.22  11.70   7.48   7.52  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28226  Release of foot tendons                           A   4.67   8.35     8.93     4.19     4.21     0.35  13.37  13.95   9.21   9.23  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28230  Incision of foot tendon(s)                        A   4.36   7.47     7.89     3.66     3.59     0.39  12.22  12.64   8.41   8.34  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28232  Incision of toe tendon                            A   3.51   7.18     7.63     3.44     3.43     0.34  11.03  11.48   7.29   7.28  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28234  Incision of foot tendon                           A   3.54   7.69     8.21     3.91     3.99     0.35  11.58  12.10   7.80   7.88  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28238  Revision of foot tendon                           A   7.96  10.49    11.13     5.68     5.81     0.86  19.31  19.95  14.50  14.63  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28240  Release of big toe                                A   4.48   7.61     7.98     3.74     3.67     0.43  12.52  12.89   8.65   8.58  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28250  Revision of foot fascia                           A   6.06   9.40    10.12     5.01     5.15     0.76  16.22  16.94  11.83  11.97  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28260  Release of midfoot joint                          A   8.19  10.53    11.52     6.05     6.35     1.03  19.75  20.74  15.27  15.57  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28261  Revision of foot tendon                           A  13.11  13.28    14.13     8.26     8.39     1.28  27.67  28.52  22.65  22.78  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28262  Revision of foot and ankle                        A  17.21  19.70    21.08    12.97    13.53     3.00  39.91  41.29  33.18  33.74  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28264  Release of midfoot joint                          A  10.65  14.65    16.99     9.16    10.21     0.81  26.11  28.45  20.62  21.67  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
28270  Release of foot contracture                       A   4.93   8.42     9.08     4.41     4.51     0.50  13.85  14.51   9.84   9.94  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28272  Release of toe joint each                         A   3.92   6.90     7.30     3.28     3.28     0.31  11.13  11.53   7.51   7.51  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28280  Fusion of toes                                    A   5.33   8.94     9.34     4.58     4.52     0.60  14.87  15.27  10.51  10.45  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28285  Repair of hammertoe                               A   4.76   8.12     8.68     4.21     4.32     0.45  13.33  13.89   9.42   9.53  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28286  Repair of hammertoe                               A   4.70   7.81     8.31     3.81     3.86     0.39  12.90  13.40   8.90   8.95  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28288  Partial removal of foot bone                      A   6.02  10.45    11.34     5.99     6.21     0.67  17.14  18.03  12.68  12.90  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28289  Repair hallux rigidus                             A   8.31  11.71    12.46     6.87     7.09     1.00  21.02  21.77  16.18  16.40  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28290  Correction of bunion                              A   5.83  10.05    10.81     5.16     5.25     0.69  16.57  17.33  11.68  11.77  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28292  Correction of bunion                              A   9.05  12.54    13.40     7.66     7.97     0.87  22.46  23.32  17.58  17.89  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28293  Correction of bunion                              A  11.48  17.27    18.25     8.42     8.66     0.95  29.70  30.68  20.85  21.09  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28294  Correction of bunion                              A   8.75  11.24    11.65     5.82     5.80     0.92  20.91  21.32  15.49  15.47  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28296  Correction of bunion                              A   8.35  11.42    11.92     6.31     6.38     0.76  20.53  21.03  15.42  15.49  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28297  Correction of bunion                              A   9.43  12.95    13.65     6.91     6.97     1.18  23.56  24.26  17.52  17.58  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28298  Correction of bunion                              A   8.13  11.47    12.26     5.93     6.06     0.87  20.47  21.26  14.93  15.06  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28299  Correction of bunion                              A  11.57  13.05    13.75     7.32     7.45     1.14  25.76  26.46  20.03  20.16  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28300  Incision of heel bone                             A   9.73   8.15NA   8.45NA   8.15     8.45     1.60  19.48  19.78  19.48  19.78  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28302  Incision of ankle bone                            A   9.74   8.71NA   9.67NA   8.71     9.67     1.91  20.36  21.32  20.36  21.32  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28304  Incision of midfoot bones                         A   9.41  12.29    13.28     6.87     7.16     1.21  22.91  23.90  17.49  17.78  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28305  Incise/graft midfoot bones                        A  10.77   7.72NA   7.67NA   7.72     7.67     0.81  19.30  19.25  19.30  19.25  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28306  Incision of metatarsal                            A   6.00  10.63    11.41     5.14     5.33     0.83  17.46  18.24  11.97  12.16  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28307  Incision of metatarsal                            A   6.50  12.46    12.54     5.95     5.94     1.28  20.24  20.32  13.73  13.72  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28308  Incision of metatarsal                            A   5.48   9.71    10.44     4.86     5.05     0.61  15.80  16.53  10.95  11.14  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28309  Incision of metatarsals                           A  14.16  10.00NA  10.60NA  10.00    10.60     2.09  26.25  26.85  26.25  26.85  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28310  Revision of big toe                               A   5.57   9.20     9.82     4.33     4.44     0.54  15.31  15.93  10.44  10.55  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28312  Revision of toe                                   A   4.69   8.99     9.61     4.16     4.20     0.50  14.18  14.80   9.35   9.39  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28313  Repair deformity of toe                           A   5.15   9.14     9.81     4.93     4.90     0.69  14.98  15.65  10.77  10.74  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28315  Removal of sesamoid bone                          A   5.00   7.99     8.51     4.01     4.08     0.49  13.48  14.00   9.50   9.57  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28320  Repair of foot bones                              A   9.37   7.37NA   7.50NA   7.37     7.50     1.39  18.13  18.26  18.13  18.26  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28322  Repair of metatarsals                             A   8.53  12.56    13.41     7.16     7.43     1.30  22.39  23.24  16.99  17.26  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28340  Resect enlarged toe tissue                        A   7.15   9.21     9.38     4.74     4.60     0.54  16.90  17.07  12.43  12.29  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28341  Resect enlarged toe                               A   8.72  10.12    10.45     5.36     5.27     0.67  19.51  19.84  14.75  14.66  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28344  Repair extra toe(s)                               A   4.40   8.12     7.85     3.95     3.64     0.34  12.86  12.59   8.69   8.38  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28345  Repair webbed toe(s)                              A   6.09   8.93     8.83     4.66     4.28     0.45  15.47  15.37  11.20  10.82  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28360  Reconstruct cleft foot                            A  14.92  12.56NA  14.52NA  12.56    14.52     3.18  30.66  32.62  30.66  32.62  0090.10.69.2120200             25.5217 090 99      0.00   0.00   0.00
28400  Treatment of heel fracture                        A   2.31   4.36     4.55     3.78     3.96     0.37   7.04   7.23   6.46   6.64  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28405  Treatment of heel fracture                        A   4.74   5.84     6.22     4.96     5.20     0.65  11.23  11.61  10.35  10.59  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28406  Treatment of heel fracture                        A   6.56   7.57NA   7.85NA   7.57     7.85     1.17  15.30  15.58  15.30  15.58  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28415  Treat heel fracture                               A  16.19  14.04NA  14.43NA  14.04    14.43     2.82  33.05  33.44  33.05  33.44  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28420  Treat/graft heel fracture                         A  17.52  15.16NA  16.53NA  15.16    16.53     3.45  36.13  37.50  36.13  37.50  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28430  Treatment of ankle fracture                       A   2.22   4.06     4.27     3.33     3.54     0.35   6.63   6.84   5.90   6.11  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28435  Treatment of ankle fracture                       A   3.54   5.56     6.29     4.68     5.23     0.69   9.79  10.52   8.91   9.46  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28436  Treatment of ankle fracture                       A   4.90   6.86NA   7.33NA   6.86     7.33     0.98  12.74  13.21  12.74  13.21  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
28445  Treat ankle fracture                              A  15.76  12.68NA  13.13NA  12.68    13.13     2.77  31.21  31.66  31.21  31.66  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28446  Osteochondral talus autogrft                      A  17.71  14.32NA  15.51NA  14.32    15.51     3.49  35.52  36.71  35.52  36.71  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28450  Treat midfoot fracture each                       A   2.03   3.77     3.94     3.12     3.28     0.30   6.10   6.27   5.45   5.61  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28455  Treat midfoot fracture each                       A   3.24   4.70     4.99     3.99     4.15     0.43   8.37   8.66   7.66   7.82  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28456  Treat midfoot fracture                            A   2.86   5.34NA   6.10NA   5.34     6.10     0.56   8.76   9.52   8.76   9.52  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28465  Treat midfoot fracture each                       A   8.80   7.78NA   8.07NA   7.78     8.07     1.26  17.84  18.13  17.84  18.13  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28470  Treat metatarsal fracture                         A   2.03   3.67     3.82     3.08     3.23     0.33   6.03   6.18   5.44   5.59  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28475  Treat metatarsal fracture                         A   3.01   4.01     4.14     3.30     3.33     0.38   7.40   7.53   6.69   6.72  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28476  Treat metatarsal fracture                         A   3.60   5.82NA   6.07NA   5.82     6.07     0.53   9.95  10.20   9.95  10.20  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28485  Treat metatarsal fracture                         A   7.44   7.11NA   7.43NA   7.11     7.43     0.95  15.50  15.82  15.50  15.82  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28490  Treat big toe fracture                            A   1.17   2.67     2.83     2.15     2.27     0.16   4.00   4.16   3.48   3.60  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28495  Treat big toe fracture                            A   1.68   3.11     3.32     2.43     2.52     0.20   4.99   5.20   4.31   4.40  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28496  Treat big toe fracture                            A   2.48   9.46     9.87     3.84     4.03     0.35  12.29  12.70   6.67   6.86  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28505  Treat big toe fracture                            A   7.44  10.79    11.39     6.10     6.54     0.92  19.15  19.75  14.46  14.90  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28510  Treatment of toe fracture                         A   1.17   2.12     2.26     2.04     2.16     0.14   3.43   3.57   3.35   3.47  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28515  Treatment of toe fracture                         A   1.56   2.76     2.93     2.32     2.40     0.18   4.50   4.67   4.06   4.14  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28525  Treat toe fracture                                A   5.62   9.94    10.47     5.24     5.59     0.71  16.27  16.80  11.57  11.92  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28530  Treat sesamoid bone fracture                      A   1.11   2.04     2.18     1.73     1.80     0.11   3.26   3.40   2.95   3.02  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28531  Treat sesamoid bone fracture                      A   2.57   7.35     7.23     2.59     2.61     0.50  10.42  10.30   5.66   5.68  0090.10.69.2120120             25.5217 090 99      0.00   0.00   0.00
28540  Treat foot dislocation                            A   2.19   3.34     3.53     2.87     2.96     0.22   5.75   5.94   5.28   5.37  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28545  Treat foot dislocation                            A   2.60   4.72     5.50     3.97     4.55     0.50   7.82   8.60   7.07   7.65  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28546  Treat foot dislocation                            A   3.40  10.98    12.58     5.27     5.87     0.67  15.05  16.65   9.34   9.94  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28555  Repair foot dislocation                           A   9.65  13.90    14.66     8.22     8.69     1.60  25.15  25.91  19.47  19.94  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28570  Treat foot dislocation                            A   1.76   2.85     2.86     2.27     2.20     0.12   4.73   4.74   4.15   4.08  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28575  Treat foot dislocation                            A   3.49   5.86     6.48     5.05     5.50     0.68  10.03  10.65   9.22   9.67  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28576  Treat foot dislocation                            A   4.60   5.46NA   6.17NA   5.46     6.17     0.90  10.96  11.67  10.96  11.67  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28585  Repair foot dislocation                           A  11.13  13.71    14.52     8.55     8.76     1.64  26.48  27.29  21.32  21.53  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28600  Treat foot dislocation                            A   2.02   3.86     4.13     3.12     3.25     0.29   6.17   6.44   5.43   5.56  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28605  Treat foot dislocation                            A   2.89   4.63     4.98     3.98     4.21     0.56   8.08   8.43   7.43   7.66  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28606  Treat foot dislocation                            A   5.09   5.45NA   5.72NA   5.45     5.72     0.84  11.38  11.65  11.38  11.65  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28615  Repair foot dislocation                           A  10.70  10.55NA  11.07NA  10.55    11.07     1.77  23.02  23.54  23.02  23.54  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28630  Treat toe dislocation                             A   1.75   2.34     2.54     1.21     1.26     0.23   4.32   4.52   3.19   3.24  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
28635  Treat toe dislocation                             A   1.96   2.90     3.11     1.76     1.83     0.22   5.08   5.29   3.94   4.01  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
28636  Treat toe dislocation                             A   2.77   4.69     4.44     2.29     1.99     0.39   7.85   7.60   5.45   5.15  0010.10.80.1020120             25.5217 090 99      0.00   0.00   0.00
28645  Repair toe dislocation                            A   7.44  10.00    10.85     5.65     6.01     0.80  18.24  19.09  13.89  14.25  0090.10.69.2120110             25.5217 090 99      0.00   0.00   0.00
28660  Treat toe dislocation                             A   1.28   1.71     1.84     1.04     1.11     0.20   3.19   3.32   2.52   2.59  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
28665  Treat toe dislocation                             A   1.97   2.25     2.39     1.70     1.74     0.24   4.46   4.60   3.91   3.95  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
28666  Treat toe dislocation                             A   2.66   2.78NA   3.10NA   2.78     3.10     0.52   5.96   6.28   5.96   6.28  0010.10.80.1020120             25.5217 090 99      0.00   0.00   0.00
28675  Repair of toe dislocation                         A   5.62  10.25    10.69     5.50     5.79     0.75  16.62  17.06  11.87  12.16  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28705  Fusion of foot bones                              A  20.33  14.46NA  14.96NA  14.46    14.96     3.45  38.24  38.74  38.24  38.74  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28715  Fusion of foot bones                              A  14.60  11.53NA  12.01NA  11.53    12.01     2.47  28.60  29.08  28.60  29.08  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28725  Fusion of foot bones                              A  12.18   9.24NA   9.61NA   9.24     9.61     1.87  23.29  23.66  23.29  23.66  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28730  Fusion of foot bones                              A  12.42  10.39NA  10.91NA  10.39    10.91     1.91  24.72  25.24  24.72  25.24  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28735  Fusion of foot bones                              A  12.23   9.35NA   9.74NA   9.35     9.74     1.78  23.36  23.75  23.36  23.75  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28737  Revision of foot bones                            A  11.03   7.77NA   7.78NA   7.77     7.78     1.28  20.08  20.09  20.08  20.09  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28740  Fusion of foot bones                              A   9.29  13.95    14.68     7.87     8.20     1.36  24.60  25.33  18.52  18.85  0090.10.69.2120210             25.5217 090 99      0.00   0.00   0.00
28750  Fusion of big toe joint                           A   8.57  14.04    14.57     7.81     8.08     1.30  23.91  24.44  17.68  17.95  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28755  Fusion of big toe joint                           A   4.88   8.94     9.40     4.29     4.33     0.52  14.34  14.80   9.69   9.73  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28760  Fusion of big toe joint                           A   9.14  12.48    13.41     6.92     7.21     1.05  22.67  23.60  17.11  17.40  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28800  Amputation of midfoot                             A   8.79   6.50NA   6.57NA   6.50     6.57     1.30  16.59  16.66  16.59  16.66  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
28805  Amputation thru metatarsal                        A  12.71   7.56NA   7.83NA   7.56     7.83     2.13  22.40  22.67  22.40  22.67  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
28810  Amputation toe & metatarsal                       A   6.64   5.26NA   5.38NA   5.26     5.38     1.18  13.08  13.20  13.08  13.20  0090.10.69.2120000             25.5217 090 99      0.00   0.00   0.00
28820  Amputation of toe                                 A   5.00   9.46     9.68     4.50     4.58     0.73  15.19  15.41  10.23  10.31  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28825  Partial amputation of toe                         A   6.01   9.90    10.33     5.11     5.35     0.84  16.75  17.18  11.96  12.20  0090.10.69.2120100             25.5217 090 99      0.00   0.00   0.00
28890  High energy eswt plantar f                        A   3.45   6.06     6.24     2.85     3.03     0.35   9.86  10.04   6.65   6.83  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
28899  Foot/toes surgery procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
29000  Application of body cast                          A   2.25   5.96     7.00     2.47     2.77     0.18   8.39   9.43   4.90   5.20  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29010  Application of body cast                          A   2.06   5.66     6.89     2.31     2.66     0.39   8.11   9.34   4.76   5.11  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29015  Application of body cast                          A   2.41   4.01     4.13     1.85     1.92     0.41   6.83   6.95   4.67   4.74  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29020  Application of body cast                          A   2.11   3.92     3.90     1.59     1.53     0.08   6.11   6.09   3.78   3.72  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29025  Application of body cast                          A   2.40   4.32     4.27     2.06     1.99     0.48   7.20   7.15   4.94   4.87  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29035  Application of body cast                          A   1.77   4.98     5.24     2.03     2.16     0.34   7.09   7.35   4.14   4.27  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29040  Application of body cast                          A   2.22   4.15     4.45     1.89     1.99     0.42   6.79   7.09   4.53   4.63  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29044  Application of body cast                          A   2.12   5.29     5.74     2.30     2.47     0.41   7.82   8.27   4.83   5.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29046  Application of body cast                          A   2.41   4.83     4.55     2.25     2.06     0.48   7.72   7.44   5.14   4.95  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29049  Application of figure eight                       A   0.89   1.59     1.81     0.85     1.02     0.18   2.66   2.88   1.92   2.09  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29055  Application of shoulder cast                      A   1.78   3.99     4.30     1.85     1.99     0.35   6.12   6.43   3.98   4.12  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29058  Application of shoulder cast                      A   1.31   1.39     1.23     0.80     0.79     0.23   2.93   2.77   2.34   2.33  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29065  Application of long arm cast                      A   0.87   1.67     1.75     0.94     1.00     0.16   2.70   2.78   1.97   2.03  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29075  Application of forearm cast                       A   0.77   1.61     1.69     0.88     0.94     0.14   2.52   2.60   1.79   1.85  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29085  Apply hand/wrist cast                             A   0.87   1.65     1.74     0.91     0.99     0.14   2.66   2.75   1.92   2.00  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29086  Apply finger cast                                 A   0.62   1.42     1.56     0.74     0.81     0.08   2.12   2.26   1.44   1.51  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29105  Apply long arm splint                             A   0.87   1.44     1.49     0.70     0.75     0.14   2.45   2.50   1.71   1.76  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29125  Apply forearm splint                              A   0.59   1.26     1.33     0.56     0.61     0.10   1.95   2.02   1.25   1.30  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29126  Apply forearm splint                              A   0.77   1.35     1.42     0.65     0.70     0.11   2.23   2.30   1.53   1.58  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29130  Application of finger splint                      A   0.50   0.58     0.61     0.26     0.28     0.07   1.15   1.18   0.83   0.85  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29131  Application of finger splint                      A   0.55   0.83     0.88     0.34     0.37     0.08   1.46   1.51   0.97   1.00  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29200  Strapping of chest                                A   0.65   0.81     0.86     0.46     0.49     0.05   1.51   1.56   1.16   1.19  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29240  Strapping of shoulder                             A   0.71   0.87     0.88     0.49     0.52     0.05   1.63   1.64   1.25   1.28  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29260  Strapping of elbow or wrist                       A   0.55   0.86     0.90     0.47     0.51     0.05   1.46   1.50   1.07   1.11  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29280  Strapping of hand or finger                       A   0.51   0.88     0.92     0.48     0.52     0.04   1.43   1.47   1.03   1.07  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29305  Application of hip cast                           A   2.03   4.43     4.73     2.19     2.31     0.39   6.85   7.15   4.61   4.73  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29325  Application of hip casts                          A   2.32   4.84     5.16     2.42     2.55     0.45   7.61   7.93   5.19   5.32  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29345  Application of long leg cast                      A   1.40   2.19     2.30     1.28     1.34     0.27   3.86   3.97   2.95   3.01  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29355  Application of long leg cast                      A   1.53   2.19     2.33     1.32     1.39     0.29   4.01   4.15   3.14   3.21  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29358  Apply long leg cast brace                         A   1.43   2.75     2.95     1.31     1.40     0.29   4.47   4.67   3.03   3.12  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29365  Application of long leg cast                      A   1.18   2.07     2.18     1.16     1.22     0.23   3.48   3.59   2.57   2.63  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29405  Apply short leg cast                              A   0.86   1.54     1.61     0.86     0.90     0.12   2.52   2.59   1.84   1.88  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29425  Apply short leg cast                              A   1.01   1.56     1.63     0.86     0.88     0.12   2.69   2.76   1.99   2.01  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29435  Apply short leg cast                              A   1.18   1.97     2.05     1.08     1.11     0.23   3.38   3.46   2.49   2.52  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29440  Addition of walker to cast                        A   0.57   0.73     0.66     0.28     0.25     0.08   1.38   1.31   0.93   0.90  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29445  Apply rigid leg cast                              A   1.78   2.03     2.08     1.16     1.20     0.24   4.05   4.10   3.18   3.22  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29450  Application of leg cast                           A   2.08   1.89     1.92     1.10     1.07     0.22   4.19   4.22   3.40   3.37  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29505  Application long leg splint                       A   0.69   1.40     1.46     0.60     0.64     0.11   2.20   2.26   1.40   1.44  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29515  Application lower leg splint                      A   0.73   1.21     1.29     0.60     0.63     0.10   2.04   2.12   1.43   1.46  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29520  Strapping of hip                                  A   0.54   0.84     0.86     0.47     0.47     0.04   1.42   1.44   1.05   1.05  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29530  Strapping of knee                                 A   0.57   0.86     0.90     0.46     0.50     0.05   1.48   1.52   1.08   1.12  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29540  Strapping of ankle and/or ft                      A   0.32   0.62     0.63     0.35     0.32     0.03   0.97   0.98   0.70   0.67  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29550  Strapping of toes                                 A   0.15   0.62     0.62     0.31     0.27     0.01   0.78   0.78   0.47   0.43  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29580  Application of paste boot                         A   0.55   0.89     0.92     0.43     0.44     0.07   1.51   1.54   1.05   1.06  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29581  Apply multlay comprs lwr leg                      A   0.60   2.04     2.04     0.27     0.27     0.07   2.71   2.71   0.94   0.94  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
29590  Application of foot splint                        A   0.76   0.71     0.74     0.32     0.31     0.05   1.52   1.55   1.13   1.12  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29700  Removal/revision of cast                          A   0.57   1.20     1.25     0.35     0.36     0.10   1.87   1.92   1.02   1.03  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29705  Removal/revision of cast                          A   0.76   1.02     1.07     0.50     0.53     0.12   1.90   1.95   1.38   1.41  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
29710  Removal/revision of cast                          A   1.34   1.87     2.02     0.85     0.93     0.27   3.48   3.63   2.46   2.54  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
29715  Removal/revision of cast                          A   0.94   1.38     1.32     0.54     0.53     0.12   2.44   2.38   1.60   1.59  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
29720  Repair of body cast                               A   0.68   1.52     1.61     0.48     0.51     0.12   2.32   2.41   1.28   1.31  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29730  Windowing of cast                                 A   0.75   0.98     1.03     0.46     0.49     0.11   1.84   1.89   1.32   1.35  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29740  Wedging of cast                                   A   1.12   1.29     1.30     0.59     0.60     0.18   2.59   2.60   1.89   1.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
29750  Wedging of clubfoot cast                          A   1.26   1.40     1.47     0.74     0.78     0.26   2.92   2.99   2.26   2.30  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
29799  Casting/strapping procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
29800  Jaw arthroscopy/surgery                           A   6.84   7.12NA   7.48NA   7.12     7.48     1.33  15.29  15.65  15.29  15.65  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
29804  Jaw arthroscopy/surgery                           A   8.87   8.51NA   9.17NA   8.51     9.17     1.74  19.12  19.78  19.12  19.78  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
29805  Shoulder arthroscopy dx                           A   6.03   6.50NA   6.80NA   6.50     6.80     1.18  13.71  14.01  13.71  14.01  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
29806  Shoulder arthroscopy/surgery                      A  15.14  13.01NA  13.60NA  13.01    13.60     2.97  31.12  31.71  31.12  31.71  0090.10.69.2131110       29805 25.5217 090 99      0.00   0.00   0.00
29807  Shoulder arthroscopy/surgery                      A  14.67  12.84NA  13.47NA  12.84    13.47     2.87  30.38  31.01  30.38  31.01  0090.10.69.2131110       29805 25.5217 090 99      0.00   0.00   0.00
29819  Shoulder arthroscopy/surgery                      A   7.79   7.81NA   8.16NA   7.81     8.16     1.52  17.12  17.47  17.12  17.47  0090.10.69.2131110       29805 25.5217 090 99      0.00   0.00   0.00
29820  Shoulder arthroscopy/surgery                      A   7.21   7.15NA   7.45NA   7.15     7.45     1.40  15.76  16.06  15.76  16.06  0090.10.69.2131210       29805 25.5217 090 99      0.00   0.00   0.00
29821  Shoulder arthroscopy/surgery                      A   7.89   7.81NA   8.15NA   7.81     8.15     1.55  17.25  17.59  17.25  17.59  0090.10.69.2131210       29805 25.5217 090 99      0.00   0.00   0.00
29822  Shoulder arthroscopy/surgery                      A   7.60   7.67NA   7.99NA   7.67     7.99     1.49  16.76  17.08  16.76  17.08  0090.10.69.2131200       29805 25.5217 090 99      0.00   0.00   0.00
29823  Shoulder arthroscopy/surgery                      A   8.36   8.32NA   8.66NA   8.32     8.66     1.63  18.31  18.65  18.31  18.65  0090.10.69.2131210       29805 25.5217 090 99      0.00   0.00   0.00
29824  Shoulder arthroscopy/surgery                      A   8.98   8.93NA   9.35NA   8.93     9.35     1.77  19.68  20.10  19.68  20.10  0090.10.69.2131210       29805 25.5217 090 99      0.00   0.00   0.00
29825  Shoulder arthroscopy/surgery                      A   7.79   7.77NA   8.11NA   7.77     8.11     1.52  17.08  17.42  17.08  17.42  0090.10.69.2131210       29805 25.5217 090 99      0.00   0.00   0.00
29826  Shoulder arthroscopy/surgery                      A   9.16   8.56NA   8.91NA   8.56     8.91     1.79  19.51  19.86  19.51  19.86  0090.10.69.2131210       29805 25.5217 090 99      0.00   0.00   0.00
29827  Arthroscop rotator cuff repr                      A  15.59  13.03NA  13.56NA  13.03    13.56     3.07  31.69  32.22  31.69  32.22  0090.10.69.2131210       29805 25.5217 090 99      0.00   0.00   0.00
29828  Arthroscopy biceps tenodesis                      A  13.16  11.14NA  11.86NA  11.14    11.86     2.58  26.88  27.60  26.88  27.60  0090.10.69.2131210       29805 25.5217 090 99      0.00   0.00   0.00
29830  Elbow arthroscopy                                 A   5.88   6.18NA   6.47NA   6.18     6.47     1.17  13.23  13.52  13.23  13.52  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
29834  Elbow arthroscopy/surgery                         A   6.42   6.71NA   7.01NA   6.71     7.01     1.22  14.35  14.65  14.35  14.65  0090.10.69.2131210       29830 25.5217 090 99      0.00   0.00   0.00
29835  Elbow arthroscopy/surgery                         A   6.62   6.85NA   7.17NA   6.85     7.17     1.29  14.76  15.08  14.76  15.08  0090.10.69.2131210       29830 25.5217 090 99      0.00   0.00   0.00
29836  Elbow arthroscopy/surgery                         A   7.72   7.78NA   8.12NA   7.78     8.12     1.52  17.02  17.36  17.02  17.36  0090.10.69.2131210       29830 25.5217 090 99      0.00   0.00   0.00
29837  Elbow arthroscopy/surgery                         A   7.01   7.07NA   7.39NA   7.07     7.39     1.36  15.44  15.76  15.44  15.76  0090.10.69.2131210       29830 25.5217 090 99      0.00   0.00   0.00
29838  Elbow arthroscopy/surgery                         A   7.88   7.89NA   8.26NA   7.89     8.26     1.49  17.26  17.63  17.26  17.63  0090.10.69.2131000       29830 25.5217 090 99      0.00   0.00   0.00
29840  Wrist arthroscopy                                 A   5.68   6.31NA   6.60NA   6.31     6.60     1.13  13.12  13.41  13.12  13.41  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
29843  Wrist arthroscopy/surgery                         A   6.15   6.69NA   7.00NA   6.69     7.00     1.21  14.05  14.36  14.05  14.36  0090.10.69.2131210       29840 25.5217 090 99      0.00   0.00   0.00
29844  Wrist arthroscopy/surgery                         A   6.51   6.80NA   7.20NA   6.80     7.20     1.18  14.49  14.89  14.49  14.89  0090.10.69.2131200       29840 25.5217 090 99      0.00   0.00   0.00
29845  Wrist arthroscopy/surgery                         A   7.69   7.67NA   8.18NA   7.67     8.18     1.37  16.73  17.24  16.73  17.24  0090.10.69.2131210       29840 25.5217 090 99      0.00   0.00   0.00
29846  Wrist arthroscopy/surgery                         A   6.89   7.09NA   7.47NA   7.09     7.47     1.22  15.20  15.58  15.20  15.58  0090.10.69.2131000       29840 25.5217 090 99      0.00   0.00   0.00
29847  Wrist arthroscopy/surgery                         A   7.22   7.21NA   7.52NA   7.21     7.52     1.41  15.84  16.15  15.84  16.15  0090.10.69.2131200       29840 25.5217 090 99      0.00   0.00   0.00
29848  Wrist endoscopy/surgery                           A   6.39   7.19NA   7.67NA   7.19     7.67     1.17  14.75  15.23  14.75  15.23  0090.10.69.2121100             25.5217 090 99      0.00   0.00   0.00
29850  Knee arthroscopy/surgery                          A   8.27   7.58NA   8.68NA   7.58     8.68     1.62  17.47  18.57  17.47  18.57  0090.10.69.2121020             25.5217 090 99      0.00   0.00   0.00
29851  Knee arthroscopy/surgery                          A  13.26  11.47NA  12.04NA  11.47    12.04     2.61  27.34  27.91  27.34  27.91  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
29855  Tibial arthroscopy/surgery                        A  10.76  10.12NA  10.59NA  10.12    10.59     2.12  23.00  23.47  23.00  23.47  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
29856  Tibial arthroscopy/surgery                        A  14.28  12.20NA  12.76NA  12.20    12.76     2.82  29.30  29.86  29.30  29.86  0090.10.69.2121220             25.5217 090 99      0.00   0.00   0.00
29860  Hip arthroscopy dx                                A   9.00   8.52NA   9.11NA   8.52     9.11     1.78  19.30  19.89  19.30  19.89  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
29861  Hip arthro w/fb removal                           A  10.10   9.17NA   9.77NA   9.17     9.77     1.97  21.24  21.84  21.24  21.84  0090.10.69.2131210       29860 25.5217 090 99      0.00   0.00   0.00
29862  Hip arthr0 w/debridement                          A  11.17  10.48NA  11.08NA  10.48    11.08     2.19  23.84  24.44  23.84  24.44  0090.10.69.2131210       29860 25.5217 090 99      0.00   0.00   0.00
29863  Hip arthr0 w/synovectomy                          A  11.17  10.40NA  11.03NA  10.40    11.03     2.20  23.77  24.40  23.77  24.40  0090.10.69.2131210       29860 25.5217 090 99      0.00   0.00   0.00
29866  Autgrft implnt knee w/scope                       A  14.67  13.13NA  13.82NA  13.13    13.82     2.91  30.71  31.40  30.71  31.40  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
29867  Allgrft implnt knee w/scope                       A  18.39  15.37NA  16.33NA  15.37    16.33     3.61  37.37  38.33  37.37  38.33  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
29868  Meniscal trnspl knee w/scpe                       A  25.10  19.20NA  20.34NA  19.20    20.34     4.94  49.24  50.38  49.24  50.38  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
29870  Knee arthroscopy dx                               A   5.19  10.83    10.83     5.75     6.04     1.02  17.04  17.04  11.96  12.25  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
29871  Knee arthroscopy/drainage                         A   6.69   6.95NA   7.30NA   6.95     7.30     1.30  14.94  15.29  14.94  15.29  0090.10.69.2131100       29870 25.5217 090 99      0.00   0.00   0.00
29873  Knee arthroscopy/surgery                          A   6.24   7.67NA   8.05NA   7.67     8.05     1.22  15.13  15.51  15.13  15.51  0090.10.69.2131110       29870 25.5217 090 99      0.00   0.00   0.00
29874  Knee arthroscopy/surgery                          A   7.19   7.13NA   7.48NA   7.13     7.48     1.40  15.72  16.07  15.72  16.07  0090.10.69.2131000       29870 25.5217 090 99      0.00   0.00   0.00
29875  Knee arthroscopy/surgery                          A   6.45   6.73NA   7.04NA   6.73     7.04     1.26  14.44  14.75  14.44  14.75  0090.10.69.2131000       29870 25.5217 090 99      0.00   0.00   0.00
29876  Knee arthroscopy/surgery                          A   8.87   8.53NA   9.00NA   8.53     9.00     1.74  19.14  19.61  19.14  19.61  0090.10.69.2131100       29870 25.5217 090 99      0.00   0.00   0.00
29877  Knee arthroscopy/surgery                          A   8.30   8.21NA   8.66NA   8.21     8.66     1.62  18.13  18.58  18.13  18.58  0090.10.69.2131000       29870 25.5217 090 99      0.00   0.00   0.00
29879  Knee arthroscopy/surgery                          A   8.99   8.60NA   9.05NA   8.60     9.05     1.77  19.36  19.81  19.36  19.81  0090.10.69.2131000       29870 25.5217 090 99      0.00   0.00   0.00
29880  Knee arthroscopy/surgery                          A   9.45   8.87NA   9.35NA   8.87     9.35     1.85  20.17  20.65  20.17  20.65  0090.10.69.2131010       29870 25.5217 090 99      0.00   0.00   0.00
29881  Knee arthroscopy/surgery                          A   8.71   8.45NA   8.91NA   8.45     8.91     1.70  18.86  19.32  18.86  19.32  0090.10.69.2131000       29870 25.5217 090 99      0.00   0.00   0.00
29882  Knee arthroscopy/surgery                          A   9.60   8.90NA   9.41NA   8.90     9.41     1.89  20.39  20.90  20.39  20.90  0090.10.69.2131100       29870 25.5217 090 99      0.00   0.00   0.00
29883  Knee arthroscopy/surgery                          A  11.77  10.54NA  11.01NA  10.54    11.01     2.30  24.61  25.08  24.61  25.08  0090.10.69.2131000       29870 25.5217 090 99      0.00   0.00   0.00
29884  Knee arthroscopy/surgery                          A   8.28   8.18NA   8.63NA   8.18     8.63     1.62  18.08  18.53  18.08  18.53  0090.10.69.2131210       29870 25.5217 090 99      0.00   0.00   0.00
29885  Knee arthroscopy/surgery                          A  10.21   9.70NA  10.24NA   9.70    10.24     2.00  21.91  22.45  21.91  22.45  0090.10.69.2131210       29870 25.5217 090 99      0.00   0.00   0.00
29886  Knee arthroscopy/surgery                          A   8.49   8.34NA   8.81NA   8.34     8.81     1.66  18.49  18.96  18.49  18.96  0090.10.69.2131100       29870 25.5217 090 99      0.00   0.00   0.00
29887  Knee arthroscopy/surgery                          A  10.16   9.62NA  10.15NA   9.62    10.15     1.98  21.76  22.29  21.76  22.29  0090.10.69.2131210       29870 25.5217 090 99      0.00   0.00   0.00
29888  Knee arthroscopy/surgery                          A  14.30  11.95NA  12.53NA  11.95    12.53     2.80  29.05  29.63  29.05  29.63  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
29889  Knee arthroscopy/surgery                          A  17.41  14.92NA  15.67NA  14.92    15.67     3.41  35.74  36.49  35.74  36.49  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
29891  Ankle arthroscopy/surgery                         A   9.67   8.91NA   9.26NA   8.91     9.26     1.64  20.22  20.57  20.22  20.57  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
29892  Ankle arthroscopy/surgery                         A  10.27   7.21NA   6.18NA   7.21     6.18     2.01  19.49  18.46  19.49  18.46  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
29893  Scope plantar fasciotomy                          A   6.32  10.44    11.04     5.61     5.79     0.50  17.26  17.86  12.43  12.61  0090.10.69.2121110             25.5217 090 99      0.00   0.00   0.00
29894  Ankle arthroscopy/surgery                         A   7.35   6.52NA   6.89NA   6.52     6.89     1.22  15.09  15.46  15.09  15.46  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
29895  Ankle arthroscopy/surgery                         A   7.13   6.17NA   6.41NA   6.17     6.41     1.13  14.43  14.67  14.43  14.67  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
29897  Ankle arthroscopy/surgery                         A   7.32   6.57NA   6.75NA   6.57     6.75     1.24  15.13  15.31  15.13  15.31  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
29898  Ankle arthroscopy/surgery                         A   8.49   7.03NA   7.27NA   7.03     7.27     1.29  16.81  17.05  16.81  17.05  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
29899  Ankle arthroscopy/surgery                         A  15.41  12.47NA  12.98NA  12.47    12.98     2.87  30.75  31.26  30.75  31.26  0090.10.69.2121210             25.5217 090 99      0.00   0.00   0.00
29900  Mcp joint arthroscopy dx                          A   5.88   6.86NA   7.59NA   6.86     7.59     0.41  13.15  13.88  13.15  13.88  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
29901  Mcp joint arthroscopy surg                        A   6.59   7.20NA   7.90NA   7.20     7.90     1.29  15.08  15.78  15.08  15.78  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
29902  Mcp joint arthroscopy surg                        A   7.16   6.27NA   5.76NA   6.27     5.76     2.57  16.00  15.49  16.00  15.49  0090.10.69.2121000             25.5217 090 99      0.00   0.00   0.00
29904  Subtalar arthro w/fb rmvl                         A   8.65   8.09NA   8.68NA   8.09     8.68     1.68  18.42  19.01  18.42  19.01  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
29905  Subtalar arthro w/exc                             A   9.18   8.92NA   9.58NA   8.92     9.58     1.81  19.91  20.57  19.91  20.57  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
29906  Subtalar arthro w/deb                             A   9.65   9.42NA  10.10NA   9.42    10.10     1.89  20.96  21.64  20.96  21.64  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
29907  Subtalar arthro w/fusion                          A  12.18  10.83NA  11.62NA  10.83    11.62     2.39  25.40  26.19  25.40  26.19  0090.10.69.2121200             25.5217 090 99      0.00   0.00   0.00
29914  Hip arthro w/femoroplasty                         A  14.67  12.79NA  12.79NA  12.79    12.79     2.91  30.37  30.37  30.37  30.37  0090.10.69.2131210       29860 25.5217 090 99      0.00   0.00   0.00
29915  Hip arthro acetabuloplasty                        A  15.00  12.99NA  12.99NA  12.99    12.99     2.95  30.94  30.94  30.94  30.94  0090.10.69.2131210       29860 25.5217 090 99      0.00   0.00   0.00
29916  Hip arthro w/labral repair                        A  15.00  12.99NA  12.99NA  12.99    12.99     2.95  30.94  30.94  30.94  30.94  0090.10.69.2131210       29860 25.5217 090 99      0.00   0.00   0.00
29999  Arthroscopy of joint                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021010             25.5217 090 99      0.00   0.00   0.00
30000  Drainage of nose lesion                           A   1.48   5.06     5.16     1.80     1.91     0.22   6.76   6.86   3.50   3.61  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
30020  Drainage of nose lesion                           A   1.48   5.01     5.27     1.84     1.95     0.20   6.69   6.95   3.52   3.63  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
3006F  Cxr doc rev                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3008F  Body mass index docd                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30100  Intranasal biopsy                                 A   0.94   3.07     3.18     0.99     1.03     0.11   4.12   4.23   2.04   2.08  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
3011F  Lipid panel doc rev                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30110  Removal of nose polyp(s)                          A   1.68   4.78     5.00     1.96     2.07     0.23   6.69   6.91   3.87   3.98  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
30115  Removal of nose polyp(s)                          A   4.44   7.66NA   8.01NA   7.66     8.01     0.56  12.66  13.01  12.66  13.01  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
30117  Removal of intranasal lesion                      A   3.26  21.35    22.18     6.22     6.49     0.41  25.02  25.85   9.89  10.16  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
30118  Removal of intranasal lesion                      A   9.92  11.43NA  12.05NA  11.43    12.05     1.30  22.65  23.27  22.65  23.27  0090.10.76.1420110             25.5217 090 99      0.00   0.00   0.00
30120  Revision of nose                                  A   5.39   9.01     9.32     6.88     7.02     0.84  15.24  15.55  13.11  13.25  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
30124  Removal of nose lesion                            A   3.20   4.43NA   4.68NA   4.43     4.68     0.41   8.04   8.29   8.04   8.29  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
30125  Removal of nose lesion                            A   7.30   9.80NA  10.23NA   9.80    10.23     0.92  18.02  18.45  18.02  18.45  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
30130  Excise inferior turbinate                         A   3.47   7.21NA   7.49NA   7.21     7.49     0.43  11.11  11.39  11.11  11.39  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
3014F  Screen mammo doc rev                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30140  Resect inferior turbinate                         A   3.57   8.80NA   9.17NA   8.80     9.17     0.45  12.82  13.19  12.82  13.19  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
3015F  Cerv cancer screen docd                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30150  Partial removal of nose                           A   9.55  12.03NA  12.37NA  12.03    12.37     1.41  22.99  23.33  22.99  23.33  0090.10.76.1420110             25.5217 090 99      0.00   0.00   0.00
3016F  Pt scrnd unhlthy OH use                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30160  Removal of nose                                   A   9.99  11.81NA  12.29NA  11.81    12.29     1.28  23.08  23.56  23.08  23.56  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3017F  Colorectal ca screen doc rev                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3018F  Pre-prxd rsk et al docd                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3020F  Lvf assess                                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30200  Injection treatment of nose                       A   0.78   2.43     2.53     0.90     0.95     0.10   3.31   3.41   1.78   1.83  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
3021F  Lvef mod/sever deprs syst                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30210  Nasal sinus therapy                               A   1.13   3.09     3.23     1.67     1.75     0.14   4.36   4.50   2.94   3.02  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
3022F  Lvef >=40% systolic                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30220  Insert nasal septal button                        A   1.59   6.92     7.24     1.92     2.02     0.22   8.73   9.05   3.73   3.83  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
3023F  Spirom doc rev                                    M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3025F  Spirom fev/fvc<70% w/copd                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3027F  Spirom fev/fvc>=70%/w/o copd                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3028F  O2 saturation doc rev                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30300  Remove nasal foreign body                         A   1.09   5.43     5.54     2.41     2.53     0.14   6.66   6.77   3.64   3.76  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
30310  Remove nasal foreign body                         A   2.01   3.77NA   3.91NA   3.77     3.91     0.26   6.04   6.18   6.04   6.18  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
30320  Remove nasal foreign body                         A   4.64   8.07NA   8.40NA   8.07     8.40     0.60  13.31  13.64  13.31  13.64  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
3035F  O2 saturation<=88% /pao<=55                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3037F  O2 saturation> 88% /pao>55                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3038F  Pulm fx w/in 12 mon b/4 surg                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3040F  Fev<40% predicted value                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30400  Reconstruction of nose                            R  10.86  17.92NA  18.23NA  17.92    18.23     1.39  30.17  30.48  30.17  30.48  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
30410  Reconstruction of nose                            R  14.00  19.68NA  20.08NA  19.68    20.08     1.79  35.47  35.87  35.47  35.87  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
3042F  Fev>=40% predicted value                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30420  Reconstruction of nose                            R  16.90  21.30NA  22.28NA  21.30    22.28     2.39  40.59  41.57  40.59  41.57  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
30430  Revision of nose                                  R   8.24  16.89NA  16.68NA  16.89    16.68     1.62  26.75  26.54  26.75  26.54  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
30435  Revision of nose                                  R  12.73  21.16NA  22.28NA  21.16    22.28     1.63  35.52  36.64  35.52  36.64  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
3044F  Hg a1c level lt 7.0%                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3045F  Hg a1c level 7.0-9.0%                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30450  Revision of nose                                  R  19.66  23.11NA  23.42NA  23.11    23.42     2.51  45.28  45.59  45.28  45.59  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
3046F  Hemoglobin a1c level > 9.0%                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30460  Revision of nose                                  A  10.32  10.28NA  10.65NA  10.28    10.65     2.01  22.61  22.98  22.61  22.98  0090.10.76.1420220             25.5217 090 99      0.00   0.00   0.00
30462  Revision of nose                                  A  20.28  21.85NA  23.50NA  21.85    23.50     3.99  46.12  47.77  46.12  47.77  0090.10.76.1420220             25.5217 090 99      0.00   0.00   0.00
30465  Repair nasal stenosis                             A  12.36  14.90NA  15.74NA  14.90    15.74     1.74  29.00  29.84  29.00  29.84  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
3048F  Ldl-c <100 mg/dl                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3049F  Ldl-c 100-129 mg/dl                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3050F  Ldl-c >= 130 mg/dl                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30520  Repair of nasal septum                            A   7.01  10.26NA  11.00NA  10.26    11.00     0.90  18.17  18.91  18.17  18.91  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
30540  Repair nasal defect                               A   7.92  11.10NA  11.90NA  11.10    11.90     1.02  20.04  20.84  20.04  20.84  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
30545  Repair nasal defect                               A  11.62  13.12NA  12.29NA  13.12    12.29     0.81  25.55  24.72  25.55  24.72  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
30560  Release of nasal adhesions                        A   1.31   6.42     6.57     2.60     2.68     0.18   7.91   8.06   4.09   4.17  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
30580  Repair upper jaw fistula                          A   6.88  10.74    11.45     6.93     7.58     0.87  18.49  19.20  14.68  15.33  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
3060F  Pos microalbuminuria rev                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30600  Repair mouth/nose fistula                         A   6.16   9.93    10.36     5.87     6.18     0.77  16.86  17.29  12.80  13.11  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
3061F  Neg microalbuminuria rev                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3062F  Pos macroalbuminuria rev                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30620  Intranasal reconstruction                         A   6.16  11.22NA  11.65NA  11.22    11.65     0.88  18.26  18.69  18.26  18.69  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
30630  Repair nasal septum defect                        A   7.29  10.16NA  10.68NA  10.16    10.68     0.99  18.44  18.96  18.44  18.96  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
3066F  Nephropathy doc tx                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3072F  Low risk for retinopathy                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3073F  Pre-surg eye measures docd                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3074F  Syst bp lt 130 mm hg                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3075F  Syst bp ge 130 - 139mm hg                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3077F  Syst bp >= 140 mm hg                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3078F  Diast bp < 80 mm hg                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3079F  Diast bp 80-89 mm hg                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3080F  Diast bp >= 90 mm hg                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30801  Ablate inf turbinate superf                       A   1.14   5.35     5.46     2.68     2.81     0.14   6.63   6.74   3.96   4.09  0010.10.80.1022100             25.5217 090 99      0.00   0.00   0.00
30802  Ablate inf turbinate submuc                       A   2.08   6.15     6.33     3.23     3.41     0.27   8.50   8.68   5.58   5.76  0010.10.80.1022100             25.5217 090 99      0.00   0.00   0.00
3082F  Kt/v <1.2                                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3083F  Kt/v > 1.2 <1.7                                   M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3084F  Kt/v ge 1.7                                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3085F  Suicide risk assessed                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3088F  Mdd mild                                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3089F  Mdd moderate                                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3090F  Mdd severe w/o psych                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30901  Control of nosebleed                              A   1.10   1.57     1.55     0.43     0.47     0.16   2.83   2.81   1.69   1.73  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
30903  Control of nosebleed                              A   1.54   4.02     4.23     0.63     0.70     0.23   5.79   6.00   2.40   2.47  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
30905  Control of nosebleed                              A   1.97   4.91     5.16     0.79     0.84     0.30   7.18   7.43   3.06   3.11  0000.00.00.0022100             25.5217 090 99      0.00   0.00   0.00
30906  Repeat control of nosebleed                       A   2.45   5.36     5.58     1.22     1.30     0.33   8.14   8.36   4.00   4.08  0000.00.00.0022100             25.5217 090 99      0.00   0.00   0.00
3091F  Mdd severe w/psych                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30915  Ligation nasal sinus artery                       A   7.44   8.61NA   9.12NA   8.61     9.12     0.99  17.04  17.55  17.04  17.55  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
3092F  Mdd in remission                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30920  Ligation upper jaw artery                         A  11.14  11.98NA  12.82NA  11.98    12.82     1.45  24.57  25.41  24.57  25.41  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
3093F  Doc new diag 1st/addl mdd                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30930  Ther fx nasal inf turbinate                       A   1.31   2.13NA   2.25NA   2.13     2.25     0.18   3.62   3.74   3.62   3.74  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
3095F  Central dexa results docd                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3096F  Central dexa ordered                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
30999  Nasal surgery procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
3100F  Image test ref carot diam                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31000  Irrigation maxillary sinus                        A   1.20   3.93     4.05     1.75     1.82     0.14   5.27   5.39   3.09   3.16  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
31002  Irrigation sphenoid sinus                         A   1.96   3.68NA   3.78NA   3.68     3.78     0.26   5.90   6.00   5.90   6.00  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
31020  Exploration maxillary sinus                       A   3.07  10.65    10.83     6.95     7.21     0.39  14.11  14.29  10.41  10.67  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
31030  Exploration maxillary sinus                       A   6.01  13.45    13.74     8.55     9.00     0.75  20.21  20.50  15.31  15.76  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
31032  Explore sinus remove polyps                       A   6.69   9.25NA   9.74NA   9.25     9.74     0.87  16.81  17.30  16.81  17.30  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
31040  Exploration behind upper jaw                      A   9.77  10.92NA  11.56NA  10.92    11.56     1.39  22.08  22.72  22.08  22.72  0090.10.76.1420110             25.5217 090 99      0.00   0.00   0.00
31050  Exploration sphenoid sinus                        A   5.37   8.33NA   8.60NA   8.33     8.60     0.68  14.38  14.65  14.38  14.65  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
31051  Sphenoid sinus surgery                            A   7.25  10.81NA  11.35NA  10.81    11.35     0.91  18.97  19.51  18.97  19.51  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
31070  Exploration of frontal sinus                      A   4.40   7.90NA   8.25NA   7.90     8.25     0.58  12.88  13.23  12.88  13.23  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
31075  Exploration of frontal sinus                      A   9.51  12.37NA  12.98NA  12.37    12.98     1.22  23.10  23.71  23.10  23.71  0090.10.76.1421210             25.5217 090 99      0.00   0.00   0.00
31080  Removal of frontal sinus                          A  12.74  15.70NA  16.92NA  15.70    16.92     1.63  30.07  31.29  30.07  31.29  0090.10.76.1421200             25.5217 090 99      0.00   0.00   0.00
31081  Removal of frontal sinus                          A  14.19  21.39NA  24.18NA  21.39    24.18     5.08  40.66  43.45  40.66  43.45  0090.10.76.1421210             25.5217 090 99      0.00   0.00   0.00
31084  Removal of frontal sinus                          A  14.95  17.59NA  18.22NA  17.59    18.22     1.91  34.45  35.08  34.45  35.08  0090.10.76.1421210             25.5217 090 99      0.00   0.00   0.00
31085  Removal of frontal sinus                          A  15.64  18.18NA  18.63NA  18.18    18.63     5.61  39.43  39.88  39.43  39.88  0090.10.76.1421210             25.5217 090 99      0.00   0.00   0.00
31086  Removal of frontal sinus                          A  14.36  16.87NA  17.87NA  16.87    17.87     1.85  33.08  34.08  33.08  34.08  0090.10.76.1421200             25.5217 090 99      0.00   0.00   0.00
31087  Removal of frontal sinus                          A  14.57  15.74NA  16.51NA  15.74    16.51     1.86  32.17  32.94  32.17  32.94  0090.10.76.1421210             25.5217 090 99      0.00   0.00   0.00
31090  Exploration of sinuses                            A  11.17  17.28NA  18.29NA  17.28    18.29     1.47  29.92  30.93  29.92  30.93  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
3110F  Pres/absn hmrhg/lesion docd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3111F  Ct/mri brain done w/in 24hrs                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3112F  Ct/mri brain done >24 hrs                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3120F  12-lead ecg performed                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31200  Removal of ethmoid sinus                          A   5.14  10.20NA  10.62NA  10.20    10.62     0.73  16.07  16.49  16.07  16.49  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
31201  Removal of ethmoid sinus                          A   8.60  11.87NA  12.55NA  11.87    12.55     1.14  21.61  22.29  21.61  22.29  0090.10.76.1421100             25.5217 090 99      0.00   0.00   0.00
31205  Removal of ethmoid sinus                          A  10.58  13.67NA  14.61NA  13.67    14.61     1.59  25.84  26.78  25.84  26.78  0090.10.76.1421210             25.5217 090 99      0.00   0.00   0.00
31225  Removal of upper jaw                              A  26.70  24.67NA  26.80NA  24.67    26.80     3.54  54.91  57.04  54.91  57.04  0090.10.76.1421210             25.5217 090 99      0.00   0.00   0.00
31230  Removal of upper jaw                              A  30.82  26.50NA  28.87NA  26.50    28.87     3.95  61.27  63.64  61.27  63.64  0090.10.76.1421210             25.5217 090 99      0.00   0.00   0.00
31231  Nasal endoscopy dx                                A   1.10   4.39     4.48     1.06     1.13     0.12   5.61   5.70   2.28   2.35  0000.00.00.0022100             25.5217 090 99      0.00   0.00   0.00
31233  Nasal/sinus endoscopy dx                          A   2.18   5.36     5.50     1.65     1.76     0.29   7.83   7.97   4.12   4.23  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
31235  Nasal/sinus endoscopy dx                          A   2.64   5.91     6.00     1.88     2.00     0.33   8.88   8.97   4.85   4.97  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
31237  Nasal/sinus endoscopy surg                        A   2.98   6.25     6.40     2.08     2.24     0.38   9.61   9.76   5.44   5.60  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
31238  Nasal/sinus endoscopy surg                        A   3.26   6.22     6.37     2.24     2.40     0.41   9.89  10.04   5.91   6.07  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
31239  Nasal/sinus endoscopy surg                        A   9.33   9.37NA  10.11NA   9.37    10.11     1.24  19.94  20.68  19.94  20.68  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
31240  Nasal/sinus endoscopy surg                        A   2.61   1.89NA   2.02NA   1.89     2.02     0.34   4.84   4.97   4.84   4.97  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
31254  Revision of ethmoid sinus                         A   4.64   3.00NA   3.23NA   3.00     3.23     0.60   8.24   8.47   8.24   8.47  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
31255  Removal of ethmoid sinus                          A   6.95   4.25NA   4.58NA   4.25     4.58     0.88  12.08  12.41  12.08  12.41  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
31256  Exploration maxillary sinus                       A   3.29   2.26NA   2.42NA   2.26     2.42     0.41   5.96   6.12   5.96   6.12  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
31267  Endoscopy maxillary sinus                         A   5.45   3.43NA   3.70NA   3.43     3.70     0.69   9.57   9.84   9.57   9.84  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
31276  Sinus endoscopy surgical                          A   8.84   5.27NA   5.69NA   5.27     5.69     1.14  15.25  15.67  15.25  15.67  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
31287  Nasal/sinus endoscopy surg                        A   3.91   2.59NA   2.79NA   2.59     2.79     0.50   7.00   7.20   7.00   7.20  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
31288  Nasal/sinus endoscopy surg                        A   4.57   2.96NA   3.18NA   2.96     3.18     0.60   8.13   8.35   8.13   8.35  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
31290  Nasal/sinus endoscopy surg                        A  18.61  13.47NA  14.46NA  13.47    14.46     2.63  34.71  35.70  34.71  35.70  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
31291  Nasal/sinus endoscopy surg                        A  19.56  14.11NA  15.18NA  14.11    15.18     3.14  36.81  37.88  36.81  37.88  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
31292  Nasal/sinus endoscopy surg                        A  15.90  11.94NA  12.81NA  11.94    12.81     2.04  29.88  30.75  29.88  30.75  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
31293  Nasal/sinus endoscopy surg                        A  17.47  12.85NA  13.81NA  12.85    13.81     2.23  32.55  33.51  32.55  33.51  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
31294  Nasal/sinus endoscopy surg                        A  20.31  14.38NA  15.48NA  14.38    15.48     2.61  37.30  38.40  37.30  38.40  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
31295  Sinus endo w/balloon dil                          A   2.70  57.07    57.07     2.12     2.12     0.35  60.12  60.12   5.17   5.17  0000.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
31296  Sinus endo w/balloon dil                          A   3.29 108.70   108.70     2.47     2.47     0.42 112.41 112.41   6.18   6.18  0000.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
31297  Sinus endo w/balloon dil                          A   2.64 108.37   108.37     2.08     2.08     0.34 111.35 111.35   5.06   5.06  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
31299  Sinus surgery procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
3130F  Upper gi endoscopy performed                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31300  Removal of larynx lesion                          A  15.91  19.46NA  20.57NA  19.46    20.57     2.02  37.39  38.50  37.39  38.50  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3132F  Doc ref upper gi endoscopy                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31320  Diagnostic incision larynx                        A   5.73  12.83NA  13.28NA  12.83    13.28     0.72  19.28  19.73  19.28  19.73  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
31360  Removal of larynx                                 A  29.91  27.04NA  29.89NA  27.04    29.89     3.91  60.86  63.71  60.86  63.71  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31365  Removal of larynx                                 A  38.81  31.68NA  35.10NA  31.68    35.10     5.07  75.56  78.98  75.56  78.98  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31367  Partial removal of larynx                         A  30.57  30.46NA  32.90NA  30.46    32.90     3.97  65.00  67.44  65.00  67.44  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31368  Partial removal of larynx                         A  34.19  33.61NA  36.20NA  33.61    36.20     4.37  72.17  74.76  72.17  74.76  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31370  Partial removal of larynx                         A  27.57  29.95NA  32.12NA  29.95    32.12     3.53  61.05  63.22  61.05  63.22  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31375  Partial removal of larynx                         A  26.07  28.46NA  30.60NA  28.46    30.60     3.35  57.88  60.02  57.88  60.02  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31380  Partial removal of larynx                         A  25.57  28.16NA  30.30NA  28.16    30.30     3.29  57.02  59.16  57.02  59.16  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31382  Partial removal of larynx                         A  28.57  30.32NA  32.71NA  30.32    32.71     3.68  62.57  64.96  62.57  64.96  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31390  Removal of larynx & pharynx                       A  42.51  35.65NA  38.98NA  35.65    38.98     5.83  83.99  87.32  83.99  87.32  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31395  Reconstruct larynx & pharynx                      A  43.80  39.26NA  42.76NA  39.26    42.76     5.62  88.68  92.18  88.68  92.18  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3140F  Upper gi endo shows barrtts                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31400  Revision of larynx                                A  11.60  16.55NA  17.19NA  16.55    17.19     1.49  29.64  30.28  29.64  30.28  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
3141F  Upper gi endo not barrtts                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3142F  Barium swallow test ordered                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31420  Removal of epiglottis                             A  11.43  11.90NA  12.64NA  11.90    12.64     1.47  24.80  25.54  24.80  25.54  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3150F  Forceps esoph biopsy done                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31500  Insert emergency airway                           A   2.33   0.60NA   0.64NA   0.60     0.64     0.31   3.24   3.28   3.24   3.28  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
31502  Change of windpipe airway                         A   0.65   0.32NA   0.34NA   0.32     0.34     0.07   1.04   1.06   1.04   1.06  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31505  Diagnostic laryngoscopy                           A   0.61   1.77     1.79     0.77     0.81     0.07   2.45   2.47   1.45   1.49  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31510  Laryngoscopy with biopsy                          A   1.92   4.07     4.15     1.45     1.55     0.26   6.25   6.33   3.63   3.73  0000.00.00.0030000       31505 25.5217 090 99      0.00   0.00   0.00
31511  Remove foreign body larynx                        A   2.16   3.76     3.85     1.37     1.42     0.31   6.23   6.32   3.84   3.89  0000.00.00.0030100       31505 25.5217 090 99      0.00   0.00   0.00
31512  Removal of larynx lesion                          A   2.07   3.84     3.95     1.58     1.70     0.27   6.18   6.29   3.92   4.04  0000.00.00.0030000       31505 25.5217 090 99      0.00   0.00   0.00
31513  Injection into vocal cord                         A   2.10   1.61NA   1.72NA   1.61     1.72     0.27   3.98   4.09   3.98   4.09  0000.00.00.0030000       31505 25.5217 090 99      0.00   0.00   0.00
31515  Laryngoscopy for aspiration                       A   1.80   4.12     4.16     1.25     1.32     0.24   6.16   6.20   3.29   3.36  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31520  Dx laryngoscopy newborn                           A   2.56   1.80NA   1.99NA   1.80     1.99     0.33   4.69   4.88   4.69   4.88  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
31525  Dx laryngoscopy excl nb                           A   2.63   4.46     4.62     1.83     1.95     0.34   7.43   7.59   4.80   4.92  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31526  Dx laryngoscopy w/oper scope                      A   2.57   1.86NA   1.99NA   1.86     1.99     0.33   4.76   4.89   4.76   4.89  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31527  Laryngoscopy for treatment                        A   3.27   2.19NA   2.41NA   2.19     2.41     0.41   5.87   6.09   5.87   6.09  0000.00.00.0030000       31525 25.5217 090 99      0.00   0.00   0.00
31528  Laryngoscopy and dilation                         A   2.37   1.69NA   1.82NA   1.69     1.82     0.31   4.37   4.50   4.37   4.50  0000.00.00.0030000       31525 25.5217 090 99      0.00   0.00   0.00
31529  Laryngoscopy and dilation                         A   2.68   1.87NA   2.00NA   1.87     2.00     0.34   4.89   5.02   4.89   5.02  0000.00.00.0030000       31525 25.5217 090 99      0.00   0.00   0.00
31530  Laryngoscopy w/fb removal                         A   3.38   2.16NA   2.33NA   2.16     2.33     0.43   5.97   6.14   5.97   6.14  0000.00.00.0030100       31525 25.5217 090 99      0.00   0.00   0.00
31531  Laryngoscopy w/fb & op scope                      A   3.58   2.40NA   2.57NA   2.40     2.57     0.45   6.43   6.60   6.43   6.60  0000.00.00.0030000       31526 25.5217 090 99      0.00   0.00   0.00
31535  Laryngoscopy w/biopsy                             A   3.16   2.17NA   2.33NA   2.17     2.33     0.41   5.74   5.90   5.74   5.90  0000.00.00.0030100       31525 25.5217 090 99      0.00   0.00   0.00
31536  Laryngoscopy w/bx & op scope                      A   3.55   2.40NA   2.58NA   2.40     2.58     0.45   6.40   6.58   6.40   6.58  0000.00.00.0030100       31526 25.5217 090 99      0.00   0.00   0.00
31540  Laryngoscopy w/exc of tumor                       A   4.12   2.70NA   2.90NA   2.70     2.90     0.53   7.35   7.55   7.35   7.55  0000.00.00.0030100       31525 25.5217 090 99      0.00   0.00   0.00
31541  Larynscop w/tumr exc + scope                      A   4.52   2.93NA   3.14NA   2.93     3.14     0.58   8.03   8.24   8.03   8.24  0000.00.00.0030100       31526 25.5217 090 99      0.00   0.00   0.00
31545  Remove vc lesion w/scope                          A   6.30   3.89NA   4.22NA   3.89     4.22     0.80  10.99  11.32  10.99  11.32  0000.00.00.0031100       31526 25.5217 090 99      0.00   0.00   0.00
31546  Remove vc lesion scope/graft                      A   9.73   5.67NA   6.27NA   5.67     6.27     1.25  16.65  17.25  16.65  17.25  0000.00.00.0031100       31526 25.5217 090 99      0.00   0.00   0.00
3155F  Cytogen test marrow b/4 tx                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31560  Laryngoscop w/arytenoidectom                      A   5.45   3.38NA   3.66NA   3.38     3.66     0.69   9.52   9.80   9.52   9.80  0000.00.00.0030000       31525 25.5217 090 99      0.00   0.00   0.00
31561  Larynscop remve cart + scop                       A   5.99   3.66NA   3.97NA   3.66     3.97     0.76  10.41  10.72  10.41  10.72  0000.00.00.0030000       31526 25.5217 090 99      0.00   0.00   0.00
31570  Laryngoscope w/vc inj                             A   3.86   5.81     5.90     2.53     2.72     0.53  10.20  10.29   6.92   7.11  0000.00.00.0030100       31525 25.5217 090 99      0.00   0.00   0.00
31571  Laryngoscop w/vc inj + scope                      A   4.26   2.77NA   2.98NA   2.77     2.98     0.54   7.57   7.78   7.57   7.78  0000.00.00.0030100       31526 25.5217 090 99      0.00   0.00   0.00
31575  Diagnostic laryngoscopy                           A   1.10   2.18     2.21     1.06     1.11     0.12   3.40   3.43   2.28   2.33  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31576  Laryngoscopy with biopsy                          A   1.97   4.45     4.52     1.50     1.60     0.24   6.66   6.73   3.71   3.81  0000.00.00.0030100       31575 25.5217 090 99      0.00   0.00   0.00
31577  Remove foreign body larynx                        A   2.47   4.39     4.52     1.68     1.78     0.33   7.19   7.32   4.48   4.58  0000.00.00.0030000       31575 25.5217 090 99      0.00   0.00   0.00
31578  Removal of larynx lesion                          A   2.84   5.16     5.30     1.96     2.16     0.35   8.35   8.49   5.15   5.35  0000.00.00.0030000       31575 25.5217 090 99      0.00   0.00   0.00
31579  Diagnostic laryngoscopy                           A   2.26   3.83     3.85     1.69     1.81     0.30   6.39   6.41   4.25   4.37  0XXX.00.00.0030100       31575 25.5217 030 99      0.00   0.00   0.00
31580  Revision of larynx                                A  14.66  19.45NA  20.63NA  19.45    20.63     1.87  35.98  37.16  35.98  37.16  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31582  Revision of larynx                                A  23.22  30.26NA  31.48NA  30.26    31.48     2.99  56.47  57.69  56.47  57.69  0090.10.76.1420110             25.5217 090 99      0.00   0.00   0.00
31584  Treat larynx fracture                             A  20.47  21.75NA  23.03NA  21.75    23.03     2.62  44.84  46.12  44.84  46.12  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31587  Revision of larynx                                A  15.27  12.44NA  13.62NA  12.44    13.62     1.94  29.65  30.83  29.65  30.83  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31588  Revision of larynx                                A  14.99  16.94NA  17.96NA  16.94    17.96     1.93  33.86  34.88  33.86  34.88  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
31590  Reinnervate larynx                                A   7.85  17.54NA  17.94NA  17.54    17.94     1.02  26.41  26.81  26.41  26.81  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31595  Larynx nerve surgery                              A   8.84  12.71NA  13.23NA  12.71    13.23     1.14  22.69  23.21  22.69  23.21  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31599  Larynx surgery procedure                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
3160F  Doc fe+ stores b/4 epo thx                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31600  Incision of windpipe                              A   7.17   3.44NA   3.66NA   3.44     3.66     1.26  11.87  12.09  11.87  12.09  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31601  Incision of windpipe                              A   4.44   2.84NA   3.06NA   2.84     3.06     0.56   7.84   8.06   7.84   8.06  0000.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
31603  Incision of windpipe                              A   4.14   1.87NA   2.02NA   1.87     2.02     0.69   6.70   6.85   6.70   6.85  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31605  Incision of windpipe                              A   3.57   1.26NA   1.34NA   1.26     1.34     0.62   5.45   5.53   5.45   5.53  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31610  Incision of windpipe                              A   9.38  10.38NA  10.99NA  10.38    10.99     1.32  21.08  21.69  21.08  21.69  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
31611  Surgery/speech prosthesis                         A   6.00   9.16NA   9.60NA   9.16     9.60     0.76  15.92  16.36  15.92  16.36  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31612  Puncture/clear windpipe                           A   0.91   1.38     1.44     0.40     0.44     0.11   2.40   2.46   1.42   1.46  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
31613  Repair windpipe opening                           A   4.71   7.84NA   8.16NA   7.84     8.16     0.72  13.27  13.59  13.27  13.59  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
31614  Repair windpipe opening                           A   8.63  12.35NA  13.10NA  12.35    13.10     1.18  22.16  22.91  22.16  22.91  0090.10.76.1420100             25.5217 090 99      0.00   0.00   0.00
31615  Visualization of windpipe                         A   2.09   3.05     3.12     1.48     1.58     0.26   5.40   5.47   3.83   3.93  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31620  Endobronchial us add-on                           A   1.40   6.69     6.28     0.50     0.50     0.12   8.21   7.80   2.02   2.02  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
31622  Dx bronchoscope/wash                              A   2.78   6.14     5.84     1.23     1.27     0.34   9.26   8.96   4.35   4.39  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31623  Dx bronchoscope/brush                             A   2.88   6.80     6.29     1.20     1.25     0.26   9.94   9.43   4.34   4.39  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31624  Dx bronchoscope/lavage                            A   2.88   6.14     5.75     1.22     1.27     0.26   9.28   8.89   4.36   4.41  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31625  Bronchoscopy w/biopsy(s)                          A   3.36   6.30     5.91     1.38     1.43     0.31   9.97   9.58   5.05   5.10  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31626  Bronchoscopy w/markers                            A   4.16   8.59     8.59     1.73     1.73     0.31  13.06  13.06   6.20   6.20  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
31627  Navigational bronchoscopy                         A   2.00  35.43    35.43     0.88     0.88     0.14  37.57  37.57   3.02   3.02  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
31628  Bronchoscopy/lung bx each                         A   3.80   7.58     6.80     1.50     1.57     0.30  11.68  10.90   5.60   5.67  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31629  Bronchoscopy/needle bx each                       A   4.09  13.74    12.45     1.61     1.69     0.34  18.17  16.88   6.04   6.12  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31630  Bronchoscopy dilate/fx repr                       A   3.81   1.75NA   1.76NA   1.75     1.76     0.49   6.05   6.06   6.05   6.06  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31631  Bronchoscopy dilate w/stent                       A   4.36   1.94NA   1.98NA   1.94     1.98     0.60   6.90   6.94   6.90   6.94  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31632  Bronchoscopy/lung bx addl                         A   1.03   1.00     0.99     0.35     0.37     0.07   2.10   2.09   1.45   1.47  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
31633  Bronchoscopy/needle bx addl                       A   1.32   1.16     1.14     0.45     0.47     0.10   2.58   2.56   1.87   1.89  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
31634  Bronch w/balloon occlusion                        A   4.00  48.98    48.98     1.76     1.76     0.33  53.31  53.31   6.09   6.09  0000.00.00.0030200       31622 25.5217 090 99      0.00   0.00   0.00
31635  Bronchoscopy w/fb removal                         A   3.67   6.18     5.79     1.55     1.59     0.39  10.24   9.85   5.61   5.65  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31636  Bronchoscopy bronch stents                        A   4.30   1.83NA   1.82NA   1.83     1.82     0.56   6.69   6.68   6.69   6.68  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31637  Bronchoscopy stent add-on                         A   1.58   0.59NA   0.61NA   0.59     0.61     0.11   2.28   2.30   2.28   2.30  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
31638  Bronchoscopy revise stent                         A   4.88   2.12NA   2.15NA   2.12     2.15     0.65   7.65   7.68   7.65   7.68  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31640  Bronchoscopy w/tumor excise                       A   4.93   2.15NA   2.17NA   2.15     2.17     0.64   7.72   7.74   7.72   7.74  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31641  Bronchoscopy treat blockage                       A   5.02   2.09NA   2.18NA   2.09     2.18     0.58   7.69   7.78   7.69   7.78  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31643  Diag bronchoscope/catheter                        A   3.49   1.40NA   1.45NA   1.40     1.45     0.29   5.18   5.23   5.18   5.23  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31645  Bronchoscopy clear airways                        A   3.16   5.49     5.17     1.31     1.36     0.29   8.94   8.62   4.76   4.81  0000.00.00.0030100       31622 25.5217 090 99      0.00   0.00   0.00
31646  Bronchoscopy reclear airway                       A   2.72   5.17     4.87     1.15     1.20     0.26   8.15   7.85   4.13   4.18  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31656  Bronchoscopy inj for x-ray                        A   2.17   6.74     6.07     0.92     0.93     0.16   9.07   8.40   3.25   3.26  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
3170F  Flow cyto done b/4 tx                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
31715  Injection for bronchus x-ray                      A   1.11   0.39NA   0.37NA   0.39     0.37     0.08   1.58   1.56   1.58   1.56  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
31717  Bronchial brush biopsy                            A   2.12   6.14     5.43     0.97     1.03     0.16   8.42   7.71   3.25   3.31  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31720  Clearance of airways                              A   1.06   0.38NA   0.41NA   0.38     0.41     0.08   1.52   1.55   1.52   1.55  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31725  Clearance of airways                              A   1.96   0.65NA   0.73NA   0.65     0.73     0.20   2.81   2.89   2.81   2.89  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31730  Intro windpipe wire/tube                          A   2.85  26.77    29.77     1.13     1.20     0.45  30.07  33.07   4.43   4.50  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
31750  Repair of windpipe                                A  15.39  22.68NA  23.74NA  22.68    23.74     2.27  40.34  41.40  40.34  41.40  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31755  Repair of windpipe                                A  17.54  31.20NA  32.42NA  31.20    32.42     2.24  50.98  52.20  50.98  52.20  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31760  Repair of windpipe                                A  23.48  12.79NA  12.37NA  12.79    12.37     5.47  41.74  41.32  41.74  41.32  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31766  Reconstruction of windpipe                        A  31.67  15.01NA  14.67NA  15.01    14.67     7.39  54.07  53.73  54.07  53.73  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31770  Repair/graft of bronchus                          A  23.54  11.44NA  11.19NA  11.44    11.19     5.49  40.47  40.22  40.47  40.22  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31775  Reconstruct bronchus                              A  24.59  11.10NA  10.49NA  11.10    10.49     5.74  41.43  40.82  41.43  40.82  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
31780  Reconstruct windpipe                              A  19.84  12.75NA  13.54NA  12.75    13.54     3.22  35.81  36.60  35.81  36.60  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31781  Reconstruct windpipe                              A  24.85  12.17NA  11.21NA  12.17    11.21     5.80  42.82  41.86  42.82  41.86  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31785  Remove windpipe lesion                            A  18.35  11.38NA  12.19NA  11.38    12.19     2.61  32.34  33.15  32.34  33.15  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31786  Remove windpipe lesion                            A  25.42  13.04NA  12.19NA  13.04    12.19     5.95  44.41  43.56  44.41  43.56  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31800  Repair of windpipe injury                         A   8.18  11.49NA  12.03NA  11.49    12.03     1.05  20.72  21.26  20.72  21.26  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
31805  Repair of windpipe injury                         A  13.42   8.19NA   7.95NA   8.19     7.95     3.15  24.76  24.52  24.76  24.52  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
31820  Closure of windpipe lesion                        A   4.64   7.53     7.89     4.48     4.77     0.67  12.84  13.20   9.79  10.08  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
31825  Repair of windpipe defect                         A   7.07   9.80    10.28     6.33     6.73     0.99  17.86  18.34  14.39  14.79  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
31830  Revise windpipe scar                              A   4.62   7.63     8.00     4.85     5.13     0.71  12.96  13.33  10.18  10.46  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
31899  Airways surgical procedure                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
3200F  Barium swallow test not req                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32035  Exploration of chest                              A  11.29   7.81NA   8.00NA   7.81     8.00     2.57  21.67  21.86  21.67  21.86  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32036  Exploration of chest                              A  12.30   8.21NA   8.28NA   8.21     8.28     2.89  23.40  23.47  23.40  23.47  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32095  Biopsy through chest wall                         A  10.14   6.59NA   6.60NA   6.59     6.60     2.34  19.07  19.08  19.07  19.08  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3210F  Grp a strep test performed                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32100  Exploration/biopsy of chest                       A  16.16   9.09NA   8.95NA   9.09     8.95     3.79  29.04  28.90  29.04  28.90  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32110  Explore/repair chest                              A  25.28  13.10NA  13.30NA  13.10    13.30     5.73  44.11  44.31  44.11  44.31  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32120  Re-exploration of chest                           A  14.39   8.70NA   8.65NA   8.70     8.65     3.40  26.49  26.44  26.49  26.44  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32124  Explore chest free adhesions                      A  15.45   9.01NA   9.03NA   9.01     9.03     3.67  28.13  28.15  28.13  28.15  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32140  Removal of lung lesion(s)                         A  16.66   9.43NA   9.38NA   9.43     9.38     3.88  29.97  29.92  29.97  29.92  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32141  Remove/treat lung lesions                         A  27.18  12.76NA  13.02NA  12.76    13.02     6.38  46.32  46.58  46.32  46.58  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3215F  Pt immunity to hep a docd                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32150  Removal of lung lesion(s)                         A  16.82   9.55NA   9.60NA   9.55     9.60     3.92  30.29  30.34  30.29  30.34  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32151  Remove lung foreign body                          A  16.94   9.74NA   9.43NA   9.74     9.43     3.97  30.65  30.34  30.65  30.34  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3216F  Pt immunity to hep b docd                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32160  Open chest heart massage                          A  13.10   7.39NA   7.53NA   7.39     7.53     2.99  23.48  23.62  23.48  23.62  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3218F  Rna tstng hep c docd done                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3220F  Hep c quant rna tstng docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32200  Drain open lung lesion                            A  18.68  11.27NA  11.45NA  11.27    11.45     4.28  34.23  34.41  34.23  34.41  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32201  Drain percut lung lesion                          A   3.99  22.93    21.28     1.66     1.49     0.38  27.30  25.65   6.03   5.86  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
32215  Treat chest lining                                A  13.05   8.15NA   8.07NA   8.15     8.07     3.04  24.24  24.16  24.24  24.16  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32220  Release of lung                                   A  26.65  15.41NA  15.22NA  15.41    15.22     6.29  48.35  48.16  48.35  48.16  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32225  Partial release of lung                           A  16.75   9.54NA   9.52NA   9.54     9.52     3.91  30.20  30.18  30.20  30.18  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3230F  Note hring tst w/in 6 mon                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32310  Removal of chest lining                           A  15.28   8.90NA   8.82NA   8.90     8.82     3.61  27.79  27.71  27.79  27.71  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32320  Free/remove chest lining                          A  27.25  14.96NA  14.95NA  14.96    14.95     6.31  48.52  48.51  48.52  48.51  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32400  Needle biopsy chest lining                        A   1.76   2.49     2.31     0.69     0.65     0.18   4.43   4.25   2.63   2.59  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
32402  Open biopsy chest lining                          A   8.97   6.11NA   6.06NA   6.11     6.06     2.02  17.10  17.05  17.10  17.05  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32405  Biopsy lung or mediastinum                        A   1.93   0.81     0.71     0.80     0.71     0.18   2.92   2.82   2.91   2.82  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
32420  Puncture/clear lung                               A   2.18   0.88NA   0.82NA   0.88     0.82     0.24   3.30   3.24   3.30   3.24  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
32421  Thoracentesis for aspiration                      A   1.54   2.90     2.66     0.60     0.59     0.14   4.58   4.34   2.28   2.27  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
32422  Thoracentesis w/tube insert                       A   2.19   3.40     3.14     1.27     1.20     0.22   5.81   5.55   3.68   3.61  0000.00.00.0021110             25.5217 090 99      0.00   0.00   0.00
32440  Removal of lung                                   A  27.28  14.26NA  13.89NA  14.26    13.89     6.34  47.88  47.51  47.88  47.51  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32442  Sleeve pneumonectomy                              A  56.47  22.80NA  23.22NA  22.80    23.22     4.24  83.51  83.93  83.51  83.93  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32445  Removal of lung                                   A  63.84  27.39NA  28.23NA  27.39    28.23    14.91 106.14 106.98 106.14 106.98  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32480  Partial removal of lung                           A  25.82  13.44NA  13.16NA  13.44    13.16     6.04  45.30  45.02  45.30  45.02  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32482  Bilobectomy                                       A  27.44  14.59NA  14.32NA  14.59    14.32     6.41  48.44  48.17  48.44  48.17  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32484  Segmentectomy                                     A  25.38  12.64NA  12.39NA  12.64    12.39     5.89  43.91  43.66  43.91  43.66  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32486  Sleeve lobectomy                                  A  42.88  18.64NA  18.67NA  18.64    18.67    10.12  71.64  71.67  71.64  71.67  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32488  Completion pneumonectomy                          A  42.99  19.60NA  19.86NA  19.60    19.86    10.09  72.68  72.94  72.68  72.94  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32491  Lung volume reduction                             R  25.24  14.05NA  13.53NA  14.05    13.53     5.87  45.16  44.64  45.16  44.64  0090.10.76.1421210             25.5217 090 99      0.00   0.00   0.00
3250F  Nonprim loc anat bx site tum                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32500  Partial removal of lung                           A  24.64  13.50NA  13.18NA  13.50    13.18     5.79  43.93  43.61  43.93  43.61  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32501  Repair bronchus add-on                            A   4.68   1.77NA   1.70NA   1.77     1.70     1.09   7.54   7.47   7.54   7.47  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
32503  Resect apical lung tumor                          A  31.74  15.99NA  15.61NA  15.99    15.61     7.48  55.21  54.83  55.21  54.83  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32504  Resect apical lung tum/chest                      A  36.54  17.75NA  16.88NA  17.75    16.88     8.50  62.79  61.92  62.79  61.92  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32540  Removal of lung lesion                            A  30.35  14.72NA  14.85NA  14.72    14.85     7.09  52.16  52.29  52.16  52.29  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32550  Insert pleural cath                               A   4.17  18.65    17.51     1.94     1.86     0.69  23.51  22.37   6.80   6.72  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
32551  Insertion of chest tube                           A   3.29   1.34NA   1.30NA   1.34     1.30     0.52   5.15   5.11   5.15   5.11  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
32552  Remove lung catheter                              A   2.53   2.43     2.43     1.76     1.76     0.60   5.56   5.56   4.89   4.89  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
32553  Ins mark thor for rt perq                         A   3.80  13.63    13.63     1.54     1.54     0.88  18.31  18.31   6.22   6.22  0000.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
32560  Treat pleurodesis w/agent                         A   1.54   5.89     5.21     0.68     0.57     0.27   7.70   7.02   2.49   2.38  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
32561  Lyse chest fibrin init day                        A   1.39   1.21     1.21     0.51     0.51     0.24   2.84   2.84   2.14   2.14  0000.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
32562  Lyse chest fibrin subq day                        A   1.24   1.08     1.08     0.46     0.46     0.23   2.55   2.55   1.93   1.93  0000.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
3260F  Pt cat/pn cat/hist grd docd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32601  Thoracoscopy diagnostic                           A   5.45   2.70NA   2.64NA   2.70     2.64     1.26   9.41   9.35   9.41   9.35  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
32602  Thoracoscopy diagnostic                           A   5.95   2.89NA   2.83NA   2.89     2.83     1.36  10.20  10.14  10.20  10.14  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
32603  Thoracoscopy diagnostic                           A   7.80   3.56NA   3.43NA   3.56     3.43     1.94  13.30  13.17  13.30  13.17  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
32604  Thoracoscopy diagnostic                           A   8.77   3.97NA   3.77NA   3.97     3.77     2.04  14.78  14.58  14.78  14.58  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
32605  Thoracoscopy diagnostic                           A   6.92   3.20NA   3.12NA   3.20     3.12     1.62  11.74  11.66  11.74  11.66  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
32606  Thoracoscopy diagnostic                           A   8.39   3.83NA   3.72NA   3.83     3.72     1.93  14.15  14.04  14.15  14.04  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
3265F  Rna tstng hepc vir ord/docd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32650  Thoracoscopy surgical                             A  10.83   6.97NA   6.81NA   6.97     6.81     2.47  20.27  20.11  20.27  20.11  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32651  Thoracoscopy surgical                             A  18.78   9.89NA  10.11NA   9.89    10.11     4.30  32.97  33.19  32.97  33.19  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32652  Thoracoscopy surgical                             A  29.13  14.23NA  14.43NA  14.23    14.43     6.71  50.07  50.27  50.07  50.27  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32653  Thoracoscopy surgical                             A  18.17   9.49NA   9.63NA   9.49     9.63     4.11  31.77  31.91  31.77  31.91  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32654  Thoracoscopy surgical                             A  20.52  10.31NA  10.46NA  10.31    10.46     4.64  35.47  35.62  35.47  35.62  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32655  Thoracoscopy surgical                             A  16.17   8.98NA   9.03NA   8.98     9.03     3.76  28.91  28.96  28.91  28.96  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32656  Thoracoscopy surgical                             A  13.26   8.00NA   7.83NA   8.00     7.83     3.00  24.26  24.09  24.26  24.09  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32657  Thoracoscopy surgical                             A  12.93   7.98NA   7.81NA   7.98     7.81     3.03  23.94  23.77  23.94  23.77  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32658  Thoracoscopy surgical                             A  11.71   7.35NA   7.02NA   7.35     7.02     2.74  21.80  21.47  21.80  21.47  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
32659  Thoracoscopy surgical                             A  11.94   7.61NA   7.37NA   7.61     7.37     2.80  22.35  22.11  22.35  22.11  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3266F  Hepc gn tstng docd b/4txmnt                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32660  Thoracoscopy surgical                             A  17.77   9.71NA   9.35NA   9.71     9.35     4.44  31.92  31.56  31.92  31.56  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
32661  Thoracoscopy surgical                             A  13.33   7.91NA   7.59NA   7.91     7.59     3.12  24.36  24.04  24.36  24.04  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
32662  Thoracoscopy surgical                             A  14.99   8.82NA   8.52NA   8.82     8.52     3.49  27.30  27.00  27.30  27.00  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
32663  Thoracoscopy surgical                             A  24.64  12.29NA  12.02NA  12.29    12.02     5.73  42.66  42.39  42.66  42.39  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
32664  Thoracoscopy surgical                             A  14.28   8.16NA   7.93NA   8.16     7.93     3.35  25.79  25.56  25.79  25.56  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
32665  Thoracoscopy surgical                             A  21.53  10.75NA  10.68NA  10.75    10.68     4.59  36.87  36.80  36.87  36.80  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
3268F  Psa/t/glsc docd b/4 txmnt                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3269F  Bone scn b/4 txmnt/aftr Dx                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3270F  No bone scn b/4 txmnt/aftrDx                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3271F  Low risk prostate cancer                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3272F  Med risk prostate cancer                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3273F  High risk prostate cancer                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3274F  Prost Cncr rsk not lw/md/hgh                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3278F  Serum lvls CA/iPTH/lpd ord                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3279F  Hgb lvl >/= 13 g/dl                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3280F  Hgb lvl 11-12.9 g/dL                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32800  Repair lung hernia                                A  15.71   9.05NA   9.02NA   9.05     9.02     3.68  28.44  28.41  28.44  28.41  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3281F  Hgb lvl < 11 g/dl                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32810  Close chest after drainage                        A  14.95   8.88NA   8.69NA   8.88     8.69     3.50  27.33  27.14  27.33  27.14  0090.10.76.1420200             25.5217 090 99      0.00   0.00   0.00
32815  Close bronchial fistula                           A  50.03  22.44NA  23.31NA  22.44    23.31    11.87  84.34  85.21  84.34  85.21  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32820  Reconstruct injured chest                         A  22.51  12.92NA  12.33NA  12.92    12.33     5.27  40.70  40.11  40.70  40.11  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3284F  Iop down >15% of pre-svc lvl                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3285F  IOP down <15% of pre-svc lvl                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32850  Donor pneumonectomy                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32851  Lung transplant single                            A  41.61  27.34NA  26.31NA  27.34    26.31     9.78  78.73  77.70  78.73  77.70  0090.10.76.1420212             25.5217 090 99      0.00   0.00   0.00
32852  Lung transplant with bypass                       A  45.48  30.99NA  29.61NA  30.99    29.61    10.63  87.10  85.72  87.10  85.72  0090.10.76.1420212             25.5217 090 99      0.00   0.00   0.00
32853  Lung transplant double                            A  50.78  30.85NA  29.61NA  30.85    29.61    11.99  93.62  92.38  93.62  92.38  0090.10.76.1422212             25.5217 090 99      0.00   0.00   0.00
32854  Lung transplant with bypass                       A  54.74  34.83NA  33.44NA  34.83    33.44    12.87 102.44 101.05 102.44 101.05  0090.10.76.1422212             25.5217 090 99      0.00   0.00   0.00
32855  Prepare donor lung single                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
32856  Prepare donor lung double                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
3288F  Fall risk assessment docd                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3290F  Pt=D(Rh)- and unsensitized                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32900  Removal of rib(s)                                 A  23.81  12.75NA  13.12NA  12.75    13.12     5.47  42.03  42.40  42.03  42.40  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32905  Revise & repair chest wall                        A  23.29  11.94NA  11.64NA  11.94    11.64     5.43  40.66  40.36  40.66  40.36  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32906  Revise & repair chest wall                        A  29.30  14.20NA  13.76NA  14.20    13.76     6.86  50.36  49.92  50.36  49.92  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
3291F  Pt=d(rh)+ or sensitized                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3292F  Hiv tstng asked/docd/revwd                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3293F  Abo rh blood typing docd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3294F  Grp b strep screening docd                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
32940  Revision of lung                                  A  21.34  11.13NA  11.04NA  11.13    11.04     5.00  37.47  37.38  37.47  37.38  0090.10.76.1420210             25.5217 090 99      0.00   0.00   0.00
32960  Therapeutic pneumothorax                          A   1.84   1.92     1.76     0.86     0.83     0.42   4.18   4.02   3.12   3.09  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
32997  Total lung lavage                                 A   7.31   2.36NA   2.43NA   2.36     2.43     0.91  10.58  10.65  10.58  10.65  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
32998  Perq rf ablate tx pul tumor                       A   5.68  79.04    74.39     2.55     2.22     0.60  85.32  80.67   8.83   8.50  0000.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
32999  Chest surgery procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020111             25.5217 090 99      0.00   0.00   0.00
3300F  AJCC stage docd b/4 thxpy                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3301F  Cancer stage docd metast                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33010  Drainage of heart sac                             A   2.24   1.03NA   0.84NA   1.03     0.84     0.45   3.72   3.53   3.72   3.53  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
33011  Repeat drainage of heart sac                      A   2.24   1.00NA   0.87NA   1.00     0.87     0.49   3.73   3.60   3.73   3.60  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
33015  Incision of heart sac                             A   8.52   5.64NA   4.80NA   5.64     4.80     1.67  15.83  14.99  15.83  14.99  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33020  Incision of heart sac                             A  14.95   8.28NA   8.21NA   8.28     8.21     3.50  26.73  26.66  26.73  26.66  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33025  Incision of heart sac                             A  13.70   7.52NA   7.36NA   7.52     7.36     3.25  24.47  24.31  24.47  24.31  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33030  Partial removal of heart sac                      A  22.39  11.71NA  11.60NA  11.71    11.60     5.31  39.41  39.30  39.41  39.30  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33031  Partial removal of heart sac                      A  25.38  12.40NA  12.13NA  12.40    12.13     6.10  43.88  43.61  43.88  43.61  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33050  Removal of heart sac lesion                       A  16.97   9.64NA   9.66NA   9.64     9.66     3.97  30.58  30.60  30.58  30.60  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33120  Removal of heart lesion                           A  27.45  13.68NA  13.32NA  13.68    13.32     6.56  47.69  47.33  47.69  47.33  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33130  Removal of heart lesion                           A  24.17  12.27NA  11.95NA  12.27    11.95     6.03  42.47  42.15  42.47  42.15  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33140  Heart revascularize (tmr)                         A  28.34  13.45NA  13.06NA  13.45    13.06     7.06  48.85  48.46  48.85  48.46  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33141  Heart tmr w/other procedure                       A   2.54   1.09NA   0.93NA   1.09     0.93     0.61   4.24   4.08   4.24   4.08  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
3315F  Er+ or pr+ breast cancer                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3316F  ER- or PR- breast cancer                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3317F  Path rpt malig cancer docd                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3318F  Path rpt malig cancer docd                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3319F  X-ray/ct/ultrsnd et al ord                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3320F  No xray/ct/ et al ordd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33202  Insert epicard eltrd open                         A  13.20   7.43NA   7.11NA   7.43     7.11     3.15  23.78  23.46  23.78  23.46  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33203  Insert epicard eltrd endo                         A  13.97   7.71NA   6.99NA   7.71     6.99     3.27  24.95  24.23  24.95  24.23  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33206  Insertion of heart pacemaker                      A   7.39   5.22NA   4.36NA   5.22     4.36     1.62  14.23  13.37  14.23  13.37  0090.09.84.0720120             25.5217 090 99      0.00   0.00   0.00
33207  Insertion of heart pacemaker                      A   8.05   5.34NA   4.41NA   5.34     4.41     1.77  15.16  14.23  15.16  14.23  0090.09.84.0720120             25.5217 090 99      0.00   0.00   0.00
33208  Insertion of heart pacemaker                      A   8.77   5.69NA   4.68NA   5.69     4.68     1.91  16.37  15.36  16.37  15.36  0090.09.84.0720120             25.5217 090 99      0.00   0.00   0.00
3321F  AJCC cncr 0/IA melan docd                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33210  Insertion of heart electrode                      A   3.30   1.61NA   1.28NA   1.61     1.28     0.71   5.62   5.29   5.62   5.29  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
33211  Insertion of heart electrode                      A   3.39   1.56NA   1.30NA   1.56     1.30     0.75   5.70   5.44   5.70   5.44  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
33212  Insertion of pulse generator                      A   5.52   3.81NA   3.17NA   3.81     3.17     1.21  10.54   9.90  10.54   9.90  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33213  Insertion of pulse generator                      A   6.37   4.26NA   3.49NA   4.26     3.49     1.40  12.03  11.26  12.03  11.26  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33214  Upgrade of pacemaker system                       A   7.84   5.48NA   4.60NA   5.48     4.60     1.70  15.02  14.14  15.02  14.14  0090.09.84.0720020             25.5217 090 99      0.00   0.00   0.00
33215  Reposition pacing-defib lead                      A   4.92   3.52NA   2.89NA   3.52     2.89     1.07   9.51   8.88   9.51   8.88  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33216  Insert 1 electrode pm-defib                       A   5.87   4.61NA   3.75NA   4.61     3.75     1.28  11.76  10.90  11.76  10.90  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33217  Insert 2 electrode pm-defib                       A   5.84   4.57NA   3.77NA   4.57     3.77     1.28  11.69  10.89  11.69  10.89  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33218  Repair lead pace-defib one                        A   6.07   4.87NA   4.05NA   4.87     4.05     1.32  12.26  11.44  12.26  11.44  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
3322F  Melanoma>ajcc stage 0 or ia                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33220  Repair lead pace-defib dual                       A   6.15   4.88NA   4.04NA   4.88     4.04     1.33  12.36  11.52  12.36  11.52  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33222  Revise pocket pacemaker                           A   5.10   4.55NA   3.85NA   4.55     3.85     1.14  10.79  10.09  10.79  10.09  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33223  Revise pocket for defib                           A   6.55   4.94NA   4.02NA   4.94     4.02     1.45  12.94  12.02  12.94  12.02  0090.09.84.0720000             25.5217 090 99      0.00   0.00   0.00
33224  Insert pacing lead & connect                      A   9.04   4.83NA   3.88NA   4.83     3.88     1.98  15.85  14.90  15.85  14.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
33225  L ventric pacing lead add-on                      A   8.33   4.14NA   3.27NA   4.14     3.27     1.82  14.29  13.42  14.29  13.42  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
33226  Reposition l ventric lead                         A   8.68   4.68NA   3.77NA   4.68     3.77     1.90  15.26  14.35  15.26  14.35  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
3323F  Clin node stgng docdb/4 surg                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33233  Removal of pacemaker system                       A   3.39   3.34NA   2.73NA   3.34     2.73     0.73   7.46   6.85   7.46   6.85  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33234  Removal of pacemaker system                       A   7.91   5.54NA   4.55NA   5.54     4.55     1.74  15.19  14.20  15.19  14.20  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33235  Removal pacemaker electrode                       A  10.15   7.43NA   6.15NA   7.43     6.15     2.24  19.82  18.54  19.82  18.54  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33236  Remove electrode/thoracotomy                      A  12.73   8.19NA   7.89NA   8.19     7.89     3.18  24.10  23.80  24.10  23.80  0090.09.84.0720020             25.5217 090 99      0.00   0.00   0.00
33237  Remove electrode/thoracotomy                      A  13.84   8.73NA   7.61NA   8.73     7.61     3.23  25.80  24.68  25.80  24.68  0090.09.84.0720020             25.5217 090 99      0.00   0.00   0.00
33238  Remove electrode/thoracotomy                      A  15.40   9.61NA   9.37NA   9.61     9.37     3.68  28.69  28.45  28.69  28.45  0090.09.84.0720020             25.5217 090 99      0.00   0.00   0.00
3324F  Mri ct scan ord rvwd rqstd                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33240  Insert pulse generator                            A   7.64   5.17NA   4.13NA   5.17     4.13     1.66  14.47  13.43  14.47  13.43  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33241  Remove pulse generator                            A   3.29   3.03NA   2.43NA   3.03     2.43     0.71   7.03   6.43   7.03   6.43  0090.09.84.0720010             25.5217 090 99      0.00   0.00   0.00
33243  Remove eltrd/thoracotomy                          A  23.57  13.06NA  12.12NA  13.06    12.12     5.55  42.18  41.24  42.18  41.24  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33244  Remove eltrd transven                             A  13.99   9.61NA   7.80NA   9.61     7.80     3.10  26.70  24.89  26.70  24.89  0090.09.84.0720110             25.5217 090 99      0.00   0.00   0.00
33249  Eltrd/insert pace-defib                           A  15.17   9.88NA   7.94NA   9.88     7.94     3.31  28.36  26.42  28.36  26.42  0090.09.84.0720110             25.5217 090 99      0.00   0.00   0.00
3325F  Preop asses 4 cataract surg                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33250  Ablate heart dysrhythm focus                      A  25.90  12.97NA  12.56NA  12.97    12.56     6.45  45.32  44.91  45.32  44.91  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33251  Ablate heart dysrhythm focus                      A  28.92  14.33NA  14.16NA  14.33    14.16     6.99  50.24  50.07  50.24  50.07  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33254  Ablate atria lmtd                                 A  23.71  12.50NA  12.26NA  12.50    12.26     5.91  42.12  41.88  42.12  41.88  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33255  Ablate atria w/o bypass ext                       A  29.04  14.83NA  14.03NA  14.83    14.03     7.24  51.11  50.31  51.11  50.31  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33256  Ablate atria w/bypass exten                       A  34.90  17.11NA  16.15NA  17.11    16.15     8.73  60.74  59.78  60.74  59.78  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33257  Ablate atria lmtd add-on                          A   9.63   6.02NA   5.85NA   6.02     5.85     2.31  17.96  17.79  17.96  17.79  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
33258  Ablate atria x10sv add-on                         A  11.00   6.57NA   6.37NA   6.57     6.37     2.62  20.19  19.99  20.19  19.99  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
33259  Ablate atria w/bypass add-on                      A  14.14   8.53NA   8.24NA   8.53     8.24     3.42  26.09  25.80  26.09  25.80  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
33261  Ablate heart dysrhythm focus                      A  28.92  13.91NA  13.48NA  13.91    13.48     7.21  50.04  49.61  50.04  49.61  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33265  Ablate atria lmtd endo                            A  23.71  12.27NA  11.88NA  12.27    11.88     5.64  41.62  41.23  41.62  41.23  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33266  Ablate atria x10sv endo                           A  33.04  15.89NA  15.29NA  15.89    15.29     7.96  56.89  56.29  56.89  56.29  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3328F  Prfrmnc docd 2 wks b/4 surg                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33282  Implant pat-active ht record                      A   4.80   4.26NA   3.45NA   4.26     3.45     1.05  10.11   9.30  10.11   9.30  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33284  Remove pat-active ht record                       A   3.14   3.46NA   2.81NA   3.46     2.81     0.68   7.28   6.63   7.28   6.63  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
3330F  Imaging study ordered (bkp)                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33300  Repair of heart wound                             A  44.97  18.60NA  19.25NA  18.60    19.25    10.71  74.28  74.93  74.28  74.93  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33305  Repair of heart wound                             A  76.93  29.61NA  30.61NA  29.61    30.61    18.39 124.93 125.93 124.93 125.93  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3331F  Bk imaging tst not ordered                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33310  Exploratory heart surgery                         A  20.34  10.77NA  10.49NA  10.77    10.49     4.48  35.59  35.31  35.59  35.31  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33315  Exploratory heart surgery                         A  26.17  13.19NA  12.74NA  13.19    12.74     6.27  45.63  45.18  45.63  45.18  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33320  Repair major blood vessel(s)                      A  18.54   9.82NA   9.56NA   9.82     9.56     4.29  32.65  32.39  32.65  32.39  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33321  Repair major vessel                               A  20.81  10.82NA  10.60NA  10.82    10.60     4.86  36.49  36.27  36.49  36.27  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33322  Repair major blood vessel(s)                      A  24.42  12.62NA  12.31NA  12.62    12.31     5.85  42.89  42.58  42.89  42.58  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33330  Insert major vessel graft                         A  25.29  12.27NA  12.22NA  12.27    12.22     6.31  43.87  43.82  43.87  43.82  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33332  Insert major vessel graft                         A  24.56  12.38NA  11.80NA  12.38    11.80     6.11  43.05  42.47  43.05  42.47  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33335  Insert major vessel graft                         A  33.91  16.03NA  15.64NA  16.03    15.64     8.16  58.10  57.71  58.10  57.71  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3340F  Mammo assess inc xray docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33400  Repair of aortic valve                            A  41.50  19.20NA  18.58NA  19.20    18.58     9.87  70.57  69.95  70.57  69.95  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33401  Valvuloplasty open                                A  24.63  14.20NA  12.38NA  14.20    12.38     5.36  44.19  42.37  44.19  42.37  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33403  Valvuloplasty w/cp bypass                         A  25.61  14.19NA  13.29NA  14.19    13.29     6.38  46.18  45.28  46.18  45.28  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33404  Prepare heart-aorta conduit                       A  31.37  15.54NA  14.75NA  15.54    14.75     7.32  54.23  53.44  54.23  53.44  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33405  Replacement of aortic valve                       A  41.32  19.74NA  18.91NA  19.74    18.91     9.90  70.96  70.13  70.96  70.13  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33406  Replacement of aortic valve                       A  52.68  23.45NA  22.74NA  23.45    22.74    12.74  88.87  88.16  88.87  88.16  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3341F  Mammo assess negative docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33410  Replacement of aortic valve                       A  46.41  21.13NA  20.72NA  21.13    20.72    11.12  78.66  78.25  78.66  78.25  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33411  Replacement of aortic valve                       A  62.07  26.58NA  26.37NA  26.58    26.37    14.90 103.55 103.34 103.55 103.34  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33412  Replacement of aortic valve                       A  43.94  21.36NA  20.21NA  21.36    20.21    10.97  76.27  75.12  76.27  75.12  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33413  Replacement of aortic valve                       A  59.87  26.09NA  25.08NA  26.09    25.08    13.99  99.95  98.94  99.95  98.94  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33414  Repair of aortic valve                            A  39.37  17.87NA  17.00NA  17.87    17.00     9.82  67.06  66.19  67.06  66.19  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33415  Revision subvalvular tissue                       A  37.27  16.43NA  16.36NA  16.43    16.36     8.50  62.20  62.13  62.20  62.13  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33416  Revise ventricle muscle                           A  36.56  17.27NA  17.14NA  17.27    17.14     8.79  62.62  62.49  62.62  62.49  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33417  Repair of aortic valve                            A  29.33  15.19NA  14.62NA  15.19    14.62     7.02  51.54  50.97  51.54  50.97  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3342F  Mammo assess bengn docd                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33420  Revision of mitral valve                          A  25.79  13.70NA  15.77NA  13.70    15.77     3.53  43.02  45.09  43.02  45.09  0090.09.84.0720110             25.5217 090 99      0.00   0.00   0.00
33422  Revision of mitral valve                          A  29.73  15.01NA  14.45NA  15.01    14.45     7.40  52.14  51.58  52.14  51.58  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33425  Repair of mitral valve                            A  49.96  21.72NA  22.02NA  21.72    22.02    11.96  83.64  83.94  83.64  83.94  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33426  Repair of mitral valve                            A  43.28  20.29NA  19.69NA  20.29    19.69    10.39  73.96  73.36  73.96  73.36  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33427  Repair of mitral valve                            A  44.83  20.54NA  19.58NA  20.54    19.58    10.76  76.13  75.17  76.13  75.17  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3343F  Mammo probably bengn docd                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33430  Replacement of mitral valve                       A  50.93  23.44NA  23.15NA  23.44    23.15    12.24  86.61  86.32  86.61  86.32  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3344F  Mammo assess susp docd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3345F  Mammo assess hghlymalig doc                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33460  Revision of tricuspid valve                       A  44.70  18.62NA  18.40NA  18.62    18.40    11.15  74.47  74.25  74.47  74.25  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33463  Valvuloplasty tricuspid                           A  57.08  23.89NA  24.26NA  23.89    24.26    13.76  94.73  95.10  94.73  95.10  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33464  Valvuloplasty tricuspid                           A  44.62  19.94NA  20.07NA  19.94    20.07    10.71  75.27  75.40  75.27  75.40  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33465  Replace tricuspid valve                           A  50.72  21.63NA  21.85NA  21.63    21.85    12.26  84.61  84.83  84.61  84.83  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33468  Revision of tricuspid valve                       A  32.94  16.45NA  15.09NA  16.45    15.09     8.23  57.62  56.26  57.62  56.26  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33470  Revision of pulmonary valve                       A  21.54  12.16NA  12.51NA  12.16    12.51     5.04  38.74  39.09  38.74  39.09  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33471  Valvotomy pulmonary valve                         A  22.96  12.80NA  13.09NA  12.80    13.09     1.62  37.38  37.67  37.38  37.67  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33472  Revision of pulmonary valve                       A  23.06  11.89NA  11.09NA  11.89    11.09     1.63  36.58  35.78  36.58  35.78  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33474  Revision of pulmonary valve                       A  39.40  16.77NA  17.32NA  16.77    17.32     9.21  65.38  65.93  65.38  65.93  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33475  Replacement pulmonary valve                       A  42.40  19.19NA  18.78NA  19.19    18.78    10.58  72.17  71.76  72.17  71.76  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33476  Revision of heart chamber                         A  26.57  13.37NA  13.33NA  13.37    13.33     6.63  46.57  46.53  46.57  46.53  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33478  Revision of heart chamber                         A  27.54  14.08NA  13.53NA  14.08    13.53     6.87  48.49  47.94  48.49  47.94  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33496  Repair prosth valve clot                          A  29.84  14.68NA  14.21NA  14.68    14.21     6.97  51.49  51.02  51.49  51.02  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3350F  Mammo bx proven malig docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33500  Repair heart vessel fistula                       A  27.94  13.78NA  13.28NA  13.78    13.28     6.97  48.69  48.19  48.69  48.19  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33501  Repair heart vessel fistula                       A  19.51  10.16NA   9.91NA  10.16     9.91     4.88  34.55  34.30  34.55  34.30  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
33502  Coronary artery correction                        A  21.85  11.93NA  11.54NA  11.93    11.54     5.45  39.23  38.84  39.23  38.84  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33503  Coronary artery graft                             A  22.51  13.55NA  11.57NA  13.55    11.57     4.92  40.98  39.00  40.98  39.00  0090.09.84.0720010             25.5217 090 99      0.00   0.00   0.00
33504  Coronary artery graft                             A  25.46  13.15NA  12.85NA  13.15    12.85     6.34  44.95  44.65  44.95  44.65  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33505  Repair artery w/tunnel                            A  38.40  15.72NA  15.38NA  15.72    15.38     9.57  63.69  63.35  63.69  63.35  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33506  Repair artery translocation                       A  37.85  20.09NA  22.95NA  20.09    22.95     8.85  66.79  69.65  66.79  69.65  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33507  Repair art intramural                             A  31.40  14.32NA  13.48NA  14.32    13.48     7.33  53.05  52.21  53.05  52.21  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33508  Endoscopic vein harvest                           A   0.31   0.12NA   0.11NA   0.12     0.11     0.07   0.50   0.49   0.50   0.49  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
3351F  Neg scrn dep symp by deptool                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33510  Cabg vein single                                  A  34.98  17.04NA  16.30NA  17.04    16.30     8.39  60.41  59.67  60.41  59.67  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33511  Cabg vein two                                     A  38.45  18.51NA  17.75NA  18.51    17.75     9.23  66.19  65.43  66.19  65.43  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33512  Cabg vein three                                   A  43.98  20.52NA  19.81NA  20.52    19.81    10.58  75.08  74.37  75.08  74.37  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33513  Cabg vein four                                    A  45.37  20.61NA  20.18NA  20.61    20.18    10.95  76.93  76.50  76.93  76.50  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33514  Cabg vein five                                    A  48.08  21.84NA  21.07NA  21.84    21.07    11.52  81.44  80.67  81.44  80.67  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33516  Cabg vein six or more                             A  49.76  22.71NA  21.77NA  22.71    21.77    12.40  84.87  83.93  84.87  83.93  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33517  Cabg artery-vein single                           A   3.61   1.34NA   1.32NA   1.34     1.32     0.86   5.81   5.79   5.81   5.79  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
33518  Cabg artery-vein two                              A   7.93   2.89NA   2.90NA   2.89     2.90     1.90  12.72  12.73  12.72  12.73  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
33519  Cabg artery-vein three                            A  10.49   3.87NA   3.84NA   3.87     3.84     2.51  16.87  16.84  16.87  16.84  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
3352F  No sig dep symp by dep tool                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33521  Cabg artery-vein four                             A  12.59   4.69NA   4.62NA   4.69     4.62     3.04  20.32  20.25  20.32  20.25  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
33522  Cabg artery-vein five                             A  14.14   5.32NA   5.19NA   5.32     5.19     3.42  22.88  22.75  22.88  22.75  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
33523  Cabg art-vein six or more                         A  16.08   6.04NA   5.86NA   6.04     5.86     3.86  25.98  25.80  25.98  25.80  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
3353F  Mild-mod dep symp by deptool                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33530  Coronary artery bypass/reop                       A  10.13   3.66NA   3.69NA   3.66     3.69     2.42  16.21  16.24  16.21  16.24  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
33533  Cabg arterial single                              A  33.75  16.59NA  15.67NA  16.59    15.67     8.11  58.45  57.53  58.45  57.53  0090.09.82.0920200             25.5217 090 99      0.00   0.00   0.00
33534  Cabg arterial two                                 A  39.88  19.14NA  18.26NA  19.14    18.26     9.56  68.58  67.70  68.58  67.70  0090.09.82.0920200             25.5217 090 99      0.00   0.00   0.00
33535  Cabg arterial three                               A  44.75  20.91NA  20.04NA  20.91    20.04    10.73  76.39  75.52  76.39  75.52  0090.09.82.0920200             25.5217 090 99      0.00   0.00   0.00
33536  Cabg arterial four or more                        A  48.43  22.05NA  21.42NA  22.05    21.42    11.68  82.16  81.53  82.16  81.53  0090.09.82.0920200             25.5217 090 99      0.00   0.00   0.00
3354F  Clin sig dep sym by dep tool                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33542  Removal of heart lesion                           A  48.21  20.91NA  21.14NA  20.91    21.14    11.61  80.73  80.96  80.73  80.96  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33545  Repair of heart damage                            A  57.06  24.18NA  24.26NA  24.18    24.26    13.65  94.89  94.97  94.89  94.97  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33548  Restore/remodel ventricle                         A  54.14  24.86NA  24.05NA  24.86    24.05    13.08  92.08  91.27  92.08  91.27  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33572  Open coronary endarterectomy                      A   4.44   1.69NA   1.62NA   1.69     1.62     1.07   7.20   7.13   7.20   7.13  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
33600  Closure of valve                                  A  30.31  15.02NA  14.70NA  15.02    14.70     7.06  52.39  52.07  52.39  52.07  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33602  Closure of valve                                  A  29.34  14.37NA  14.35NA  14.37    14.35     6.23  49.94  49.92  49.94  49.92  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33606  Anastomosis/artery-aorta                          A  31.53  16.53NA  17.05NA  16.53    17.05     6.71  54.77  55.29  54.77  55.29  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33608  Repair anomaly w/conduit                          A  31.88  16.04NA  15.25NA  16.04    15.25     7.44  55.36  54.57  55.36  54.57  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33610  Repair by enlargement                             A  31.40  15.52NA  14.92NA  15.52    14.92     7.33  54.25  53.65  54.25  53.65  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33611  Repair double ventricle                           A  35.57  16.11NA  15.42NA  16.11    15.42     8.88  60.56  59.87  60.56  59.87  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33612  Repair double ventricle                           A  36.57  16.25NA  15.60NA  16.25    15.60     7.96  60.78  60.13  60.78  60.13  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33615  Repair modified fontan                            A  35.89  17.33NA  16.28NA  17.33    16.28     8.39  61.61  60.56  61.61  60.56  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33617  Repair single ventricle                           A  39.09  17.80NA  17.45NA  17.80    17.45     9.14  66.03  65.68  66.03  65.68  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33619  Repair single ventricle                           A  48.76  23.73NA  25.83NA  23.73    25.83    11.39  83.88  85.98  83.88  85.98  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33620  Apply r&l pulm art bands                          A  30.00  13.45NA  13.45NA  13.45    13.45     7.48  50.93  50.93  50.93  50.93  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33621  Transthor cath for stent                          A  16.18   7.42NA   7.42NA   7.42     7.42     3.75  27.35  27.35  27.35  27.35  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33622  Redo compl cardiac anomaly                        A  64.00  28.32NA  28.32NA  28.32    28.32    14.94 107.26 107.26 107.26 107.26  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33641  Repair heart septum defect                        A  29.58  13.76NA  13.82NA  13.76    13.82     7.10  50.44  50.50  50.44  50.50  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33645  Revision of heart veins                           A  28.10  13.79NA  13.24NA  13.79    13.24     7.01  48.90  48.35  48.90  48.35  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33647  Repair heart septum defects                       A  29.53  15.37NA  14.42NA  15.37    14.42     7.36  52.26  51.31  52.26  51.31  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33660  Repair of heart defects                           A  31.83  17.63NA  20.12NA  17.63    20.12     7.94  57.40  59.89  57.40  59.89  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33665  Repair of heart defects                           A  34.85  15.81NA  15.17NA  15.81    15.17     8.72  59.38  58.74  59.38  58.74  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33670  Repair of heart chambers                          A  36.63  15.51NA  14.84NA  15.51    14.84     9.15  61.29  60.62  61.29  60.62  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33675  Close mult vsd                                    A  35.95  16.06NA  15.43NA  16.06    15.43     8.96  60.97  60.34  60.97  60.34  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33676  Close mult vsd w/resection                        A  36.95  18.20NA  18.64NA  18.20    18.64     2.62  57.77  58.21  57.77  58.21  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33677  Cl mult vsd w/rem pul band                        A  38.45  15.85NA  13.42NA  15.85    13.42     2.73  57.03  54.60  57.03  54.60  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33681  Repair heart septum defect                        A  32.34  16.53NA  16.22NA  16.53    16.22     7.78  56.65  56.34  56.65  56.34  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33684  Repair heart septum defect                        A  34.37  15.64NA  15.00NA  15.64    15.00     8.58  58.59  57.95  58.59  57.95  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33688  Repair heart septum defect                        A  34.75  14.62NA  14.27NA  14.62    14.27     8.68  58.05  57.70  58.05  57.70  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33690  Reinforce pulmonary artery                        A  20.36  12.34NA  13.26NA  12.34    13.26     4.75  37.45  38.37  37.45  38.37  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33692  Repair of heart defects                           A  31.54  15.97NA  16.34NA  15.97    16.34     2.23  49.74  50.11  49.74  50.11  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33694  Repair of heart defects                           A  35.57  16.25NA  15.26NA  16.25    15.26     8.88  60.70  59.71  60.70  59.71  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33697  Repair of heart defects                           A  37.57  18.60NA  16.42NA  18.60    16.42     8.18  64.35  62.17  64.35  62.17  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3370F  AJCC brst cncr stage 0 docd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33702  Repair of heart defects                           A  27.24  13.58NA  13.26NA  13.58    13.26     6.79  47.61  47.29  47.61  47.29  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33710  Repair of heart defects                           A  30.41  17.10NA  14.23NA  17.10    14.23     7.10  54.61  51.74  54.61  51.74  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
3372F  Ajcc brst cncr stage 1 docd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33720  Repair of heart defect                            A  27.26  13.77NA  13.13NA  13.77    13.13     6.37  47.40  46.76  47.40  46.76  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33722  Repair of heart defect                            A  29.21  14.59NA  15.31NA  14.59    15.31     7.28  51.08  51.80  51.08  51.80  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33724  Repair venous anomaly                             A  27.63  13.55NA  12.59NA  13.55    12.59     6.44  47.62  46.66  47.62  46.66  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33726  Repair pul venous stenosis                        A  37.12  18.61NA  19.38NA  18.61    19.38     9.26  64.99  65.76  64.99  65.76  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33730  Repair heart-vein defect(s)                       A  36.14  16.00NA  16.11NA  16.00    16.11     9.03  61.17  61.28  61.17  61.28  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33732  Repair heart-vein defect                          A  28.96  14.75NA  14.22NA  14.75    14.22     7.22  50.93  50.40  50.93  50.40  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33735  Revision of heart chamber                         A  22.20  11.97NA  11.71NA  11.97    11.71     5.55  39.72  39.46  39.72  39.46  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33736  Revision of heart chamber                         A  24.32  12.92NA  12.45NA  12.92    12.45     6.06  43.30  42.83  43.30  42.83  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33737  Revision of heart chamber                         A  22.47  11.94NA  11.46NA  11.94    11.46     5.26  39.67  39.19  39.67  39.19  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3374F  Ajcc brst cncr stage 1 docd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33750  Major vessel shunt                                A  22.22  12.15NA   9.54NA  12.15     9.54     7.96  42.33  39.72  42.33  39.72  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33755  Major vessel shunt                                A  22.60  12.01NA  11.97NA  12.01    11.97     4.93  39.54  39.50  39.54  39.50  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3376F  AJCC brstcncr stage 2 docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33762  Major vessel shunt                                A  22.60  12.24NA  12.40NA  12.24    12.40     1.60  36.44  36.60  36.44  36.60  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33764  Major vessel shunt & graft                        A  22.60  12.40NA  13.22NA  12.40    13.22     4.82  39.82  40.64  39.82  40.64  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33766  Major vessel shunt                                A  23.57  12.60NA  11.20NA  12.60    11.20     5.12  41.29  39.89  41.29  39.89  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33767  Major vessel shunt                                A  25.30  12.10NA  11.93NA  12.10    11.93     6.31  43.71  43.54  43.71  43.54  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33768  Cavopulmonary shunting                            A   8.00   3.41NA   3.52NA   3.41     3.52     0.56  11.97  12.08  11.97  12.08  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
33770  Repair great vessels defect                       A  39.07  16.85NA  16.01NA  16.85    16.01     9.14  65.06  64.22  65.06  64.22  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33771  Repair great vessels defect                       A  40.63  18.49NA  19.37NA  18.49    19.37     2.89  62.01  62.89  62.01  62.89  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33774  Repair great vessels defect                       A  31.73  15.95NA  15.24NA  15.95    15.24     7.92  55.60  54.89  55.60  54.89  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33775  Repair great vessels defect                       A  32.99  17.53NA  17.69NA  17.53    17.69     2.32  52.84  53.00  52.84  53.00  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33776  Repair great vessels defect                       A  34.75  18.61NA  18.80NA  18.61    18.80     2.44  55.80  55.99  55.80  55.99  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33777  Repair great vessels defect                       A  34.17  14.86NA  12.35NA  14.86    12.35     2.42  51.45  48.94  51.45  48.94  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33778  Repair great vessels defect                       A  42.75  21.23NA  21.70NA  21.23    21.70     3.04  67.02  67.49  67.02  67.49  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33779  Repair great vessels defect                       A  43.23  20.17NA  20.79NA  20.17    20.79     3.08  66.48  67.10  66.48  67.10  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3378F  AJCC brstcncr stage 3 docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33780  Repair great vessels defect                       A  43.90  21.16NA  21.28NA  21.16    21.28     3.12  68.18  68.30  68.18  68.30  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33781  Repair great vessels defect                       A  43.21  19.60NA  20.50NA  19.60    20.50     3.08  65.89  66.79  65.89  66.79  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33782  Nikaidoh proc                                     A  60.08  24.13NA  24.13NA  24.13    24.13    14.04  98.25  98.25  98.25  98.25  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33783  Nikaidoh proc w/ostia implt                       A  65.08  25.90NA  25.90NA  25.90    25.90    15.21 106.19 106.19 106.19 106.19  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33786  Repair arterial trunk                             A  41.87  18.35NA  17.34NA  18.35    17.34     2.97  63.19  62.18  63.19  62.18  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33788  Revision of pulmonary artery                      A  27.42  13.31NA  12.54NA  13.31    12.54     1.93  42.66  41.89  42.66  41.89  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3380F  AJCC brstcncr stage 4 docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33800  Aortic suspension                                 A  17.28   8.63NA   8.52NA   8.63     8.52     4.30  30.21  30.10  30.21  30.10  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
33802  Repair vessel defect                              A  18.37  11.06NA  12.01NA  11.06    12.01     4.59  34.02  34.97  34.02  34.97  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33803  Repair vessel defect                              A  20.31   9.82NA   9.72NA   9.82     9.72     5.07  35.20  35.10  35.20  35.10  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33813  Repair septal defect                              A  21.36  13.08NA  12.39NA  13.08    12.39     5.00  39.44  38.75  39.44  38.75  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33814  Repair septal defect                              A  26.57  13.78NA  13.24NA  13.78    13.24     6.63  46.98  46.44  46.98  46.44  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3382F  AJCC cln cncr stage 0 docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33820  Revise major vessel                               A  16.69   9.20NA   8.75NA   9.20     8.75     4.17  30.06  29.61  30.06  29.61  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33822  Revise major vessel                               A  17.71  10.13NA  10.14NA  10.13    10.14     1.25  29.09  29.10  29.09  29.10  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33824  Revise major vessel                               A  20.23  11.60NA  11.86NA  11.60    11.86     4.73  36.56  36.82  36.56  36.82  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3384F  AJCC cln cncr stage 1 docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33840  Remove aorta constriction                         A  21.34  12.15NA  13.30NA  12.15    13.30     5.32  38.81  39.96  38.81  39.96  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33845  Remove aorta constriction                         A  22.93  13.07NA  11.96NA  13.07    11.96     5.72  41.72  40.61  41.72  40.61  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33851  Remove aorta constriction                         A  21.98  15.17NA  18.50NA  15.17    18.50     5.47  42.62  45.95  42.62  45.95  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33852  Repair septal defect                              A  24.41  12.46NA  11.82NA  12.46    11.82     6.08  42.95  42.31  42.95  42.31  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33853  Repair septal defect                              A  32.51  16.78NA  15.31NA  16.78    15.31     8.12  57.41  55.94  57.41  55.94  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3386F  AJCC cln cncr stage 2 docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33860  Ascending aortic graft                            A  59.46  25.17NA  25.09NA  25.17    25.09    14.22  98.85  98.77  98.85  98.77  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33863  Ascending aortic graft                            A  58.79  24.63NA  24.02NA  24.63    24.02    14.04  97.46  96.85  97.46  96.85  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33864  Ascending aortic graft                            A  60.08  25.40NA  24.42NA  25.40    24.42    14.29  99.77  98.79  99.77  98.79  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33870  Transverse aortic arch graft                      A  46.06  20.96NA  20.09NA  20.96    20.09    10.97  77.99  77.12  77.99  77.12  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33875  Thoracic aortic graft                             A  35.78  17.15NA  17.19NA  17.15    17.19     8.53  61.46  61.50  61.46  61.50  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33877  Thoracoabdominal graft                            A  69.03  26.29NA  26.65NA  26.29    26.65    16.31 111.63 111.99 111.63 111.99  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
3388F  AJCC cln cncr stage 3 docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33880  Endovasc taa repr incl subcl                      A  34.58  14.38NA  13.65NA  14.38    13.65     7.70  56.66  55.93  56.66  55.93  0090.09.84.0722220             25.5217 090 99      0.00   0.00   0.00
33881  Endovasc taa repr w/o subcl                       A  29.58  12.58NA  12.01NA  12.58    12.01     6.59  48.75  48.18  48.75  48.18  0090.09.84.0722220             25.5217 090 99      0.00   0.00   0.00
33883  Insert endovasc prosth taa                        A  21.09   9.55NA   9.15NA   9.55     9.15     4.69  35.33  34.93  35.33  34.93  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
33884  Endovasc prosth taa add-on                        A   8.20   2.84NA   2.77NA   2.84     2.77     1.83  12.87  12.80  12.87  12.80  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
33886  Endovasc prosth delayed                           A  18.09   8.30NA   7.98NA   8.30     7.98     4.29  30.68  30.36  30.68  30.36  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
33889  Artery transpose/endovas taa                      A  15.92   5.51NA   5.48NA   5.51     5.48     3.78  25.21  25.18  25.21  25.18  0000.00.00.0021220             25.5217 090 99      0.00   0.00   0.00
33891  Car-car bp grft/endovas taa                       A  20.00   6.38NA   5.96NA   6.38     5.96     4.74  31.12  30.70  31.12  30.70  0000.00.00.0021220             25.5217 090 99      0.00   0.00   0.00
3390F  AJCC cln cncr stage 4 docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33910  Remove lung artery emboli                         A  29.71  14.65NA  14.31NA  14.65    14.31     7.40  51.76  51.42  51.76  51.42  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33915  Remove lung artery emboli                         A  24.95  11.45NA  11.15NA  11.45    11.15     5.43  41.83  41.53  41.83  41.53  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33916  Surgery of great vessel                           A  28.42  14.99NA  13.31NA  14.99    13.31     7.09  50.50  48.82  50.50  48.82  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33917  Repair pulmonary artery                           A  25.30  14.15NA  12.92NA  14.15    12.92     5.91  45.36  44.13  45.36  44.13  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33920  Repair pulmonary atresia                          A  32.74  15.21NA  14.56NA  15.21    14.56     8.16  56.11  55.46  56.11  55.46  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33922  Transect pulmonary artery                         A  24.22  12.47NA  12.07NA  12.47    12.07     6.04  42.73  42.33  42.73  42.33  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33924  Remove pulmonary shunt                            A   5.49   2.00NA   1.92NA   2.00     1.92     1.28   8.77   8.69   8.77   8.69  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
33925  Rpr pul art unifocal w/o cpb                      A  31.30  14.66NA  13.59NA  14.66    13.59     7.31  53.27  52.20  53.27  52.20  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33926  Repr pul art unifocal w/cpb                       A  44.73  22.00NA  26.84NA  22.00    26.84    11.15  77.88  82.72  77.88  82.72  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
33930  Removal of donor heart/lung                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33933  Prepare donor heart/lung                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
33935  Transplantation heart/lung                        R  62.01  29.37NA  28.00NA  29.37    28.00    15.47 106.85 105.48 106.85 105.48  0090.09.84.0720212             25.5217 090 99      0.00   0.00   0.00
33940  Removal of donor heart                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
33944  Prepare donor heart                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
33945  Transplantation of heart                          R  89.50  37.17NA  37.49NA  37.17    37.49    21.29 147.96 148.28 147.96 148.28  0090.09.84.0720212             25.5217 090 99      0.00   0.00   0.00
33960  External circulation assist                       A  19.33   7.11NA   7.13NA   7.11     7.13     3.82  30.26  30.28  30.26  30.28  0000.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
33961  External circulation assist                       A  10.91   4.14NA   4.01NA   4.14     4.01     1.66  16.71  16.58  16.71  16.58  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
33967  Insert ia percut device                           A   4.84   2.35NA   1.88NA   2.35     1.88     1.07   8.26   7.79   8.26   7.79  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
33968  Remove aortic assist device                       A   0.64   0.29NA   0.25NA   0.29     0.25     0.14   1.07   1.03   1.07   1.03  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
33970  Aortic circulation assist                         A   6.74   2.85NA   2.50NA   2.85     2.50     1.56  11.15  10.80  11.15  10.80  0000.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
33971  Aortic circulation assist                         A  11.99   7.23NA   6.73NA   7.23     6.73     2.80  22.02  21.52  22.02  21.52  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33973  Insert balloon device                             A   9.75   4.19NA   3.67NA   4.19     3.67     2.25  16.19  15.67  16.19  15.67  0000.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
33974  Remove intra-aortic balloon                       A  15.03   8.98NA   7.93NA   8.98     7.93     3.76  27.77  26.72  27.77  26.72  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
33975  Implant ventricular device                        A  20.97   8.02NA   7.65NA   8.02     7.65     4.98  33.97  33.60  33.97  33.60  0XXX.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
33976  Implant ventricular device                        A  22.97   9.00NA   8.15NA   9.00     8.15     5.73  37.70  36.85  37.70  36.85  0XXX.00.00.0022200             25.5217 090 99      0.00   0.00   0.00
33977  Remove ventricular device                         A  20.28  11.98NA  11.42NA  11.98    11.42     4.81  37.07  36.51  37.07  36.51  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33978  Remove ventricular device                         A  22.72  12.80NA  12.48NA  12.80    12.48     5.68  41.20  40.88  41.20  40.88  0090.09.84.0722200             25.5217 090 99      0.00   0.00   0.00
33979  Insert intracorporeal device                      A  45.93  17.38NA  16.48NA  17.38    16.48    10.97  74.28  73.38  74.28  73.38  0XXX.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
33980  Remove intracorporeal device                      A  65.20  30.70NA  29.84NA  30.70    29.84    15.70 111.60 110.74 111.60 110.74  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
33981  Replace vad pump ext                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
33982  Replace vad intra w/o bp                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
33983  Replace vad intra w/bp                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
33999  Cardiac surgery procedure                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
34001  Removal of artery clot                            A  17.88   8.63NA   8.85NA   8.63     8.85     4.06  30.57  30.79  30.57  30.79  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34051  Removal of artery clot                            A  16.99   9.20NA   9.11NA   9.20     9.11     4.24  30.43  30.34  30.43  30.34  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34101  Removal of artery clot                            A  10.93   5.71NA   5.68NA   5.71     5.68     2.46  19.10  19.07  19.10  19.07  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34111  Removal of arm artery clot                        A  10.93   5.72NA   5.69NA   5.72     5.69     2.43  19.08  19.05  19.08  19.05  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34151  Removal of artery clot                            A  26.52  11.63NA  11.80NA  11.63    11.80     5.96  44.11  44.28  44.11  44.28  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34201  Removal of artery clot                            A  19.48   8.40NA   8.80NA   8.40     8.80     4.47  32.35  32.75  32.35  32.75  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34203  Removal of leg artery clot                        A  17.86   8.55NA   8.46NA   8.55     8.46     4.10  30.51  30.42  30.51  30.42  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34401  Removal of vein clot                              A  26.52  13.96NA  14.59NA  13.96    14.59     5.65  46.13  46.76  46.13  46.76  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34421  Removal of vein clot                              A  13.37   6.89NA   6.86NA   6.89     6.86     2.96  23.22  23.19  23.22  23.19  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34451  Removal of vein clot                              A  28.52  11.42NA  10.36NA  11.42    10.36     6.76  46.70  45.64  46.70  45.64  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34471  Removal of vein clot                              A  21.11  10.45NA  12.23NA  10.45    12.23     4.49  36.05  37.83  36.05  37.83  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
34490  Removal of vein clot                              A  10.91   5.97NA   6.05NA   5.97     6.05     2.42  19.30  19.38  19.30  19.38  0090.09.84.0721100             25.5217 090 99      0.00   0.00   0.00
3450F  Dyspnea scrnd no-mild dysp                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
34501  Repair valve femoral vein                         A  16.85   8.27NA   7.51NA   8.27     7.51     3.99  29.11  28.35  29.11  28.35  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34502  Reconstruct vena cava                             A  28.07  13.50NA  13.17NA  13.50    13.17     5.88  47.45  47.12  47.45  47.12  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
3451F  Dyspnea scrnd mod-high dysp                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
34510  Transposition of vein valve                       A  19.91  10.67NA  11.72NA  10.67    11.72     4.22  34.80  35.85  34.80  35.85  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3452F  Dyspnea not screened                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
34520  Cross-over vein graft                             A  19.18   8.38NA   7.69NA   8.38     7.69     4.54  32.10  31.41  32.10  31.41  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
34530  Leg vein fusion                                   A  17.93   8.33NA   7.62NA   8.33     7.62     3.82  30.08  29.37  30.08  29.37  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3455F  TB scrng done-interpd 6mon                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3470F  Ra disease activity low                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3471F  Ra disease activity mod                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3472F  Ra disease activity high                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3475F  Disease progn RA poor docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3476F  Disease progn RA good docd                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
34800  Endovas aaa repr w/sm tube                        A  21.54   9.56NA   9.05NA   9.56     9.05     4.56  35.66  35.15  35.66  35.15  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
34802  Endovas aaa repr w/2-p part                       A  23.79  10.54NA  10.13NA  10.54    10.13     5.08  39.41  39.00  39.41  39.00  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
34803  Endovas aaa repr w/3-p part                       A  24.82  10.57NA  10.22NA  10.57    10.22     5.32  40.71  40.36  40.71  40.36  0090.09.84.0722220             25.5217 090 99      0.00   0.00   0.00
34804  Endovas aaa repr w/1-p part                       A  23.79  10.53NA  10.12NA  10.53    10.12     5.13  39.45  39.04  39.45  39.04  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
34805  Endovas aaa repr w/long tube                      A  22.67   9.81NA   9.62NA   9.81     9.62     5.02  37.50  37.31  37.50  37.31  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
34806  Aneurysm press sensor add-on                      A   2.06   0.74NA   0.70NA   0.74     0.70     0.45   3.25   3.21   3.25   3.21  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
34808  Endovas iliac a device addon                      A   4.12   1.44NA   1.42NA   1.44     1.42     0.90   6.46   6.44   6.46   6.44  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
34812  Xpose for endoprosth femorl                       A   6.74   2.34NA   2.34NA   2.34     2.34     1.55  10.63  10.63  10.63  10.63  0000.00.00.0021220             25.5217 090 99      0.00   0.00   0.00
34813  Femoral endovas graft add-on                      A   4.79   1.62NA   1.61NA   1.62     1.61     1.10   7.51   7.50   7.51   7.50  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
34820  Xpose for endoprosth iliac                        A   9.74   3.40NA   3.35NA   3.40     3.35     2.17  15.31  15.26  15.31  15.26  0000.00.00.0021220             25.5217 090 99      0.00   0.00   0.00
34825  Endovasc extend prosth init                       A  12.80   6.56NA   6.28NA   6.56     6.28     2.74  22.10  21.82  22.10  21.82  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
34826  Endovasc exten prosth addl                        A   4.12   1.49NA   1.44NA   1.49     1.44     0.88   6.49   6.44   6.49   6.44  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
34830  Open aortic tube prosth repr                      A  35.23  13.50NA  12.45NA  13.50    12.45     8.34  57.07  56.02  57.07  56.02  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
34831  Open aortoiliac prosth repr                       A  37.98  13.91NA  13.27NA  13.91    13.27     9.00  60.89  60.25  60.89  60.25  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
34832  Open aortofemor prosth repr                       A  37.98  14.39NA  13.27NA  14.39    13.27     9.00  61.37  60.25  61.37  60.25  0090.09.84.0720220             25.5217 090 99      0.00   0.00   0.00
34833  Xpose for endoprosth iliac                        A  11.98   4.50NA   4.39NA   4.50     4.39     2.78  19.26  19.15  19.26  19.15  0000.00.00.0021220             25.5217 090 99      0.00   0.00   0.00
34834  Xpose endoprosth brachial                         A   5.34   2.13NA   2.05NA   2.13     2.05     1.24   8.71   8.63   8.71   8.63  0000.00.00.0021220             25.5217 090 99      0.00   0.00   0.00
3490F  History aids-defining cond                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
34900  Endovasc iliac repr w/graft                       A  16.85   7.96NA   7.63NA   7.96     7.63     3.57  28.38  28.05  28.38  28.05  0090.09.84.0721220             25.5217 090 99      0.00   0.00   0.00
3491F  HIV unsure baby of HIV+moms                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3492F  History cd4+ cell count <350                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3493F  No hist cd4+ cell count<350                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3494F  CD4+cell count <200cells/mm3                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3495F  Cd4+cell cnt 200-499 cells                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3496F  Cd4+ cell count + 500 cells                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3497F  CD4+ cell percentage <15%                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3498F  Cd4+ cell % >=15% (hiv)                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
3500F  Cd4+cell cnt/% docd as done                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35001  Repair defect of artery                           A  20.81  10.04NA   9.72NA  10.04     9.72     4.81  35.66  35.34  35.66  35.34  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35002  Repair artery rupture neck                        A  22.23   9.56NA   8.56NA   9.56     8.56     4.74  36.53  35.53  36.53  35.53  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35005  Repair defect of artery                           A  19.29  10.79NA  11.57NA  10.79    11.57     4.56  34.64  35.42  34.64  35.42  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35011  Repair defect of artery                           A  18.58   8.66NA   8.69NA   8.66     8.69     4.21  31.45  31.48  31.45  31.48  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35013  Repair artery rupture arm                         A  23.23  10.86NA  11.14NA  10.86    11.14     5.27  39.36  39.64  39.36  39.64  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3502F  HIV rna vrl ld <lmts quantif                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35021  Repair defect of artery                           A  22.17   9.97NA   8.77NA   9.97     8.77     5.19  37.33  36.13  37.33  36.13  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35022  Repair artery rupture chest                       A  25.70  12.04NA  12.15NA  12.04    12.15     6.00  43.74  43.85  43.74  43.85  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3503F  HIV rna vrl ldnot<lmts quntf                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35045  Repair defect of arm artery                       A  18.01   8.83NA   9.18NA   8.83     9.18     3.99  30.83  31.18  30.83  31.18  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35081  Repair defect of artery                           A  33.53  14.20NA  14.43NA  14.20    14.43     7.75  55.48  55.71  55.48  55.71  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35082  Repair artery rupture aorta                       A  42.09  17.46NA  17.73NA  17.46    17.73     9.64  69.19  69.46  69.19  69.46  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35091  Repair defect of artery                           A  35.35  13.67NA  13.38NA  13.67    13.38     8.18  57.20  56.91  57.20  56.91  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35092  Repair artery rupture aorta                       A  50.97  19.70NA  19.71NA  19.70    19.71    11.76  82.43  82.44  82.43  82.44  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3510F  Doc tb scrng-rslts interpd                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35102  Repair defect of artery                           A  36.53  14.96NA  15.07NA  14.96    15.07     8.43  59.92  60.03  59.92  60.03  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35103  Repair artery rupture groin                       A  43.62  17.39NA  17.35NA  17.39    17.35     9.97  70.98  70.94  70.98  70.94  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3511F  Chlmyd/gonrh tsts docd done                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35111  Repair defect of artery                           A  26.28  13.07NA  14.49NA  13.07    14.49     5.59  44.94  46.36  44.94  46.36  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35112  Repair artery rupture spleen                      A  32.57  15.66NA  17.39NA  15.66    17.39     6.93  55.16  56.89  55.16  56.89  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3512F  Syph scrng docd as done                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35121  Repair defect of artery                           A  31.52  13.42NA  13.64NA  13.42    13.64     7.24  52.18  52.40  52.18  52.40  0090.09.84.0721200             25.5217 090 99      0.00   0.00   0.00
35122  Repair artery rupture belly                       A  37.89  14.56NA  13.25NA  14.56    13.25     8.07  60.52  59.21  60.52  59.21  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3513F  Hep B scrng docd as done                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35131  Repair defect of artery                           A  26.40  11.67NA  11.59NA  11.67    11.59     6.08  44.15  44.07  44.15  44.07  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35132  Repair artery rupture groin                       A  32.57  12.62NA  11.66NA  12.62    11.66     7.43  52.62  51.66  52.62  51.66  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3514F  Hep C scrng docd as done                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35141  Repair defect of artery                           A  20.91   9.39NA   9.33NA   9.39     9.33     4.82  35.12  35.06  35.12  35.06  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35142  Repair artery rupture thigh                       A  25.16  11.13NA  11.01NA  11.13    11.01     5.77  42.06  41.94  42.06  41.94  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3515F  Pt has docd immun to hep C                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35151  Repair defect of artery                           A  23.72  10.46NA  10.39NA  10.46    10.39     5.46  39.64  39.57  39.64  39.57  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35152  Repair artery rupture knee                        A  27.66  11.19NA  10.19NA  11.19    10.19     6.56  45.41  44.41  45.41  44.41  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35180  Repair blood vessel lesion                        A  15.10  10.13NA  11.40NA  10.13    11.40     3.57  28.80  30.07  28.80  30.07  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35182  Repair blood vessel lesion                        A  31.71  15.02NA  14.79NA  15.02    14.79     6.75  53.48  53.25  53.48  53.25  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35184  Repair blood vessel lesion                        A  18.82   9.10NA   9.32NA   9.10     9.32     4.01  31.93  32.15  31.93  32.15  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35188  Repair blood vessel lesion                        A  15.16   7.33NA   6.46NA   7.33     6.46     3.23  25.72  24.85  25.72  24.85  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35189  Repair blood vessel lesion                        A  29.98  14.75NA  16.26NA  14.75    16.26     7.48  52.21  53.72  52.21  53.72  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35190  Repair blood vessel lesion                        A  13.42   7.08NA   7.14NA   7.08     7.14     3.06  23.56  23.62  23.56  23.62  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35201  Repair blood vessel lesion                        A  16.93   8.70NA   8.80NA   8.70     8.80     3.75  29.38  29.48  29.38  29.48  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35206  Repair blood vessel lesion                        A  13.84   7.23NA   7.40NA   7.23     7.40     3.06  24.13  24.30  24.13  24.30  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35207  Repair blood vessel lesion                        A  10.94   9.23NA   9.89NA   9.23     9.89     1.93  22.10  22.76  22.10  22.76  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
35211  Repair blood vessel lesion                        A  24.58  12.31NA  12.05NA  12.31    12.05     5.89  42.78  42.52  42.78  42.52  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35216  Repair blood vessel lesion                        A  36.61  16.99NA  17.94NA  16.99    17.94     8.62  62.22  63.17  62.22  63.17  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35221  Repair blood vessel lesion                        A  26.62  11.77NA  12.27NA  11.77    12.27     5.81  44.20  44.70  44.20  44.70  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35226  Repair blood vessel lesion                        A  15.30   7.59NA   7.39NA   7.59     7.39     3.52  26.41  26.21  26.41  26.21  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35231  Repair blood vessel lesion                        A  21.16  11.19NA  11.52NA  11.19    11.52     4.16  36.51  36.84  36.51  36.84  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35236  Repair blood vessel lesion                        A  18.02   8.65NA   8.72NA   8.65     8.72     3.98  30.65  30.72  30.65  30.72  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35241  Repair blood vessel lesion                        A  25.58  13.19NA  13.28NA  13.19    13.28     6.29  45.06  45.15  45.06  45.15  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35246  Repair blood vessel lesion                        A  28.23  12.05NA  10.48NA  12.05    10.48     6.68  46.96  45.39  46.96  45.39  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35251  Repair blood vessel lesion                        A  31.91  13.46NA  13.98NA  13.46    13.98     6.98  52.35  52.87  52.35  52.87  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35256  Repair blood vessel lesion                        A  19.06   8.72NA   8.63NA   8.72     8.63     4.35  32.13  32.04  32.13  32.04  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35261  Repair blood vessel lesion                        A  18.96   9.44NA   9.55NA   9.44     9.55     4.63  33.03  33.14  33.03  33.14  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35266  Repair blood vessel lesion                        A  15.83   7.71NA   7.75NA   7.71     7.75     3.61  27.15  27.19  27.15  27.19  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35271  Repair blood vessel lesion                        A  24.58  12.29NA  12.06NA  12.29    12.06     6.12  42.99  42.76  42.99  42.76  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35276  Repair blood vessel lesion                        A  25.83  12.81NA  12.60NA  12.81    12.60     6.03  44.67  44.46  44.67  44.46  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35281  Repair blood vessel lesion                        A  30.06  13.35NA  13.73NA  13.35    13.73     6.78  50.19  50.57  50.19  50.57  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35286  Repair blood vessel lesion                        A  17.19   8.50NA   8.42NA   8.50     8.42     3.95  29.64  29.56  29.64  29.56  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35301  Rechanneling of artery                            A  19.61   9.08NA   9.07NA   9.08     9.07     4.55  33.24  33.23  33.24  33.23  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35302  Rechanneling of artery                            A  21.35   9.19NA   9.42NA   9.19     9.42     4.92  35.46  35.69  35.46  35.69  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35303  Rechanneling of artery                            A  23.60  10.09NA  10.44NA  10.09    10.44     5.42  39.11  39.46  39.11  39.46  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35304  Rechanneling of artery                            A  24.60  10.27NA  10.51NA  10.27    10.51     5.64  40.51  40.75  40.51  40.75  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35305  Rechanneling of artery                            A  23.60  10.00NA  10.31NA  10.00    10.31     5.42  39.02  39.33  39.02  39.33  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35306  Rechanneling of artery                            A   9.25   3.51NA   4.04NA   3.51     4.04     2.19  14.95  15.48  14.95  15.48  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
35311  Rechanneling of artery                            A  28.60  12.50NA  12.27NA  12.50    12.27     6.68  47.78  47.55  47.78  47.55  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35321  Rechanneling of artery                            A  16.59   7.87NA   7.86NA   7.87     7.86     3.76  28.22  28.21  28.22  28.21  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35331  Rechanneling of artery                            A  27.72  12.32NA  12.17NA  12.32    12.17     6.42  46.46  46.31  46.46  46.31  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35341  Rechanneling of artery                            A  26.21  11.19NA  10.93NA  11.19    10.93     6.04  43.44  43.18  43.44  43.18  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35351  Rechanneling of artery                            A  24.61  10.49NA  10.53NA  10.49    10.53     5.64  40.74  40.78  40.74  40.78  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35355  Rechanneling of artery                            A  19.86   8.64NA   8.57NA   8.64     8.57     4.55  33.05  32.98  33.05  32.98  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35361  Rechanneling of artery                            A  30.24  11.94NA  10.97NA  11.94    10.97     7.17  49.35  48.38  49.35  48.38  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35363  Rechanneling of artery                            A  32.35  14.63NA  14.32NA  14.63    14.32     7.55  54.53  54.22  54.53  54.22  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35371  Rechanneling of artery                            A  15.31   7.27NA   7.27NA   7.27     7.27     3.52  26.10  26.10  26.10  26.10  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35372  Rechanneling of artery                            A  18.58   8.35NA   8.30NA   8.35     8.30     4.25  31.18  31.13  31.18  31.13  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35390  Reoperation carotid add-on                        A   3.19   1.13NA   1.11NA   1.13     1.11     0.73   5.05   5.03   5.05   5.03  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
35400  Angioscopy                                        A   3.00   1.06NA   1.01NA   1.06     1.01     0.68   4.74   4.69   4.74   4.69  0ZZZ.00.00.0000010             25.5217 090 99      0.00   0.00   0.00
35450  Repair arterial blockage                          A  10.05   3.93NA   3.82NA   3.93     3.82     2.24  16.22  16.11  16.22  16.11  0000.00.00.0021210             25.5217 090 99      0.00   0.00   0.00
35452  Repair arterial blockage                          A   6.90   2.82NA   2.79NA   2.82     2.79     1.58  11.30  11.27  11.30  11.27  0000.00.00.0021210             25.5217 090 99      0.00   0.00   0.00
35458  Repair arterial blockage                          A   9.48   3.79NA   3.80NA   3.79     3.80     2.13  15.40  15.41  15.40  15.41  0000.00.00.0021210             25.5217 090 99      0.00   0.00   0.00
35460  Repair venous blockage                            A   6.03   2.48NA   2.54NA   2.48     2.54     1.32   9.83   9.89   9.83   9.89  0000.00.00.0021110             25.5217 090 99      0.00   0.00   0.00
35471  Repair arterial blockage                          A  10.05  75.23    61.23     4.80     3.99     1.98  87.26  73.26  16.83  16.02  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
35472  Repair arterial blockage                          A   6.90  54.85    47.73     3.11     2.80     1.44  63.19  56.07  11.45  11.14  0000.00.00.0021010             25.5217 090 99      0.00   0.00   0.00
35475  Repair arterial blockage                          R   9.48  57.58    54.18     4.09     3.77     1.52  68.58  65.18  15.09  14.77  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
35476  Repair venous blockage                            A   6.03  44.97    42.38     2.71     2.52     0.83  51.83  49.24   9.57   9.38  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
3550F  Low rsk thromboembolism                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35500  Harvest vein for bypass                           A   6.44   2.22NA   2.22NA   2.22     2.22     1.49  10.15  10.15  10.15  10.15  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
35501  Artery bypass graft                               A  29.09  13.94NA  14.28NA  13.94    14.28     6.68  49.71  50.05  49.71  50.05  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35506  Artery bypass graft                               A  25.33  11.04NA  10.73NA  11.04    10.73     6.00  42.37  42.06  42.37  42.06  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35508  Artery bypass graft                               A  26.09  12.16NA  12.33NA  12.16    12.33     6.50  44.75  44.92  44.75  44.92  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35509  Artery bypass graft                               A  28.09  12.47NA  12.03NA  12.47    12.03     6.65  47.21  46.77  47.21  46.77  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3551F  Intrmed rsk thromboembolism                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35510  Artery bypass graft                               A  24.39   9.86NA   8.96NA   9.86     8.96     5.77  40.02  39.12  40.02  39.12  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35511  Artery bypass graft                               A  22.20  11.67NA  12.98NA  11.67    12.98     5.27  39.14  40.45  39.14  40.45  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35512  Artery bypass graft                               A  23.89   9.57NA   8.81NA   9.57     8.81     5.66  39.12  38.36  39.12  38.36  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35515  Artery bypass graft                               A  26.09  10.17NA   9.97NA  10.17     9.97     6.18  42.44  42.24  42.44  42.24  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35516  Artery bypass graft                               A  24.21   9.07NA   8.86NA   9.07     8.86     5.73  39.01  38.80  39.01  38.80  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35518  Artery bypass graft                               A  22.65   9.33NA   8.30NA   9.33     8.30     5.36  37.34  36.31  37.34  36.31  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3552F  Hgh risk for thromboembolism                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35521  Artery bypass graft                               A  24.13  12.21NA  13.70NA  12.21    13.70     5.72  42.06  43.55  42.06  43.55  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35522  Artery bypass graft                               A  23.15  10.25NA  10.18NA  10.25    10.18     5.47  38.87  38.80  38.87  38.80  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35523  Artery bypass graft                               A  24.13  11.19NA  10.87NA  11.19    10.87     5.47  40.79  40.47  40.79  40.47  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35525  Artery bypass graft                               A  21.69   9.71NA   9.80NA   9.71     9.80     4.82  36.22  36.31  36.22  36.31  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35526  Artery bypass graft                               A  31.55  12.81NA  11.39NA  12.81    11.39     7.88  52.24  50.82  52.24  50.82  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35531  Artery bypass graft                               A  39.11  16.14NA  16.23NA  16.14    16.23     8.89  64.14  64.23  64.14  64.23  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35533  Artery bypass graft                               A  29.92  14.66NA  16.23NA  14.66    16.23     7.09  51.67  53.24  51.67  53.24  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35535  Artery bypass graft                               A  38.13  15.00NA  13.36NA  15.00    13.36     2.70  55.83  54.19  55.83  54.19  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35536  Artery bypass graft                               A  33.73  12.85NA  12.01NA  12.85    12.01     8.00  54.58  53.74  54.58  53.74  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35537  Artery bypass graft                               A  41.88  19.29NA  21.58NA  19.29    21.58     9.91  71.08  73.37  71.08  73.37  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35538  Artery bypass graft                               A  47.03  21.52NA  23.88NA  21.52    23.88    11.14  79.69  82.05  79.69  82.05  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35539  Artery bypass graft                               A  44.11  16.03NA  15.18NA  16.03    15.18    10.46  70.60  69.75  70.60  69.75  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35540  Artery bypass graft                               A  49.33  20.01NA  20.98NA  20.01    20.98    11.33  80.67  81.64  80.67  81.64  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
35548  Artery bypass graft                               A  22.68   9.51NA   8.70NA   9.51     8.70     5.38  37.57  36.76  37.57  36.76  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35549  Artery bypass graft                               A  24.45  13.81NA  16.12NA  13.81    16.12     5.20  43.46  45.77  43.46  45.77  0090.09.84.0722210             25.5217 090 99      0.00   0.00   0.00
3555F  Pt inr measurement performed                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35551  Artery bypass graft                               A  27.83  14.19NA  15.30NA  14.19    15.30     5.93  47.95  49.06  47.95  49.06  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35556  Artery bypass graft                               A  26.75  11.51NA  11.67NA  11.51    11.67     6.12  44.38  44.54  44.38  44.54  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35558  Artery bypass graft                               A  23.13  10.70NA  10.84NA  10.70    10.84     5.32  39.15  39.29  39.15  39.29  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35560  Artery bypass graft                               A  34.03  13.27NA  12.09NA  13.27    12.09     8.07  55.37  54.19  55.37  54.19  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35563  Artery bypass graft                               A  26.12  10.46NA   9.74NA  10.46     9.74     6.18  42.76  42.04  42.76  42.04  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35565  Artery bypass graft                               A  25.13  11.11NA  11.05NA  11.11    11.05     5.73  41.97  41.91  41.97  41.91  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35566  Artery bypass graft                               A  32.35  13.35NA  13.52NA  13.35    13.52     7.48  53.18  53.35  53.18  53.35  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35570  Artery bypass graft                               A  29.15  12.10NA  10.78NA  12.10    10.78     2.06  43.31  41.99  43.31  41.99  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35571  Artery bypass graft                               A  25.52  11.09NA  10.97NA  11.09    10.97     5.88  42.49  42.37  42.49  42.37  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35572  Harvest femoropopliteal vein                      A   6.81   2.55NA   2.48NA   2.55     2.48     1.59  10.95  10.88  10.95  10.88  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
35583  Vein bypass graft                                 A  27.75  11.81NA  12.03NA  11.81    12.03     6.34  45.90  46.12  45.90  46.12  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35585  Vein bypass graft                                 A  32.35  13.64NA  13.82NA  13.64    13.82     7.39  53.38  53.56  53.38  53.56  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35587  Vein bypass graft                                 A  26.21  11.71NA  11.71NA  11.71    11.71     6.03  43.95  43.95  43.95  43.95  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35600  Harvest art for cabg add-on                       A   4.94   1.93NA   1.85NA   1.93     1.85     1.20   8.07   7.99   8.07   7.99  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
35601  Artery bypass graft                               A  27.09  12.83NA  13.27NA  12.83    13.27     6.33  46.25  46.69  46.25  46.69  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35606  Artery bypass graft                               A  22.46   9.74NA   9.63NA   9.74     9.63     5.24  37.44  37.33  37.44  37.33  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35612  Artery bypass graft                               A  16.82   7.82NA   6.95NA   7.82     6.95     3.99  28.63  27.76  28.63  27.76  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35616  Artery bypass graft                               A  21.82  10.71NA  12.05NA  10.71    12.05     4.64  37.17  38.51  37.17  38.51  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35621  Artery bypass graft                               A  21.03   9.17NA   9.11NA   9.17     9.11     4.86  35.06  35.00  35.06  35.00  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35623  Bypass graft not vein                             A  25.92  12.93NA  14.48NA  12.93    14.48     6.12  44.97  46.52  44.97  46.52  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35626  Artery bypass graft                               A  29.14  13.25NA  12.90NA  13.25    12.90     6.97  49.36  49.01  49.36  49.01  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35631  Artery bypass graft                               A  36.03  14.35NA  14.15NA  14.35    14.15     8.41  58.79  58.59  58.79  58.59  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35632  Artery bypass graft                               A  36.13  14.33NA  12.77NA  14.33    12.77     2.57  53.03  51.47  53.03  51.47  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35633  Artery bypass graft                               A  39.11  16.05NA  15.07NA  16.05    15.07     2.77  57.93  56.95  57.93  56.95  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35634  Artery bypass graft                               A  35.33  14.60NA  13.58NA  14.60    13.58     2.50  52.43  51.41  52.43  51.41  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35636  Artery bypass graft                               A  31.75  15.29NA  17.03NA  15.29    17.03     7.52  54.56  56.30  54.56  56.30  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35637  Artery bypass graft                               A  33.05  13.78NA  14.03NA  13.78    14.03     7.63  54.46  54.71  54.46  54.71  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35638  Artery bypass graft                               A  33.60  14.27NA  14.49NA  14.27    14.49     7.81  55.68  55.90  55.68  55.90  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35642  Artery bypass graft                               A  18.94  10.93NA  11.94NA  10.93    11.94     4.48  34.35  35.36  34.35  35.36  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35645  Artery bypass graft                               A  18.43   9.72NA  10.91NA   9.72    10.91     4.60  32.75  33.94  32.75  33.94  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35646  Artery bypass graft                               A  32.98  14.04NA  13.93NA  14.04    13.93     7.58  54.60  54.49  54.60  54.49  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35647  Artery bypass graft                               A  29.73  12.96NA  12.96NA  12.96    12.96     6.89  49.58  49.58  49.58  49.58  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35650  Artery bypass graft                               A  20.16   9.20NA   9.29NA   9.20     9.29     4.59  33.95  34.04  33.95  34.04  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35651  Artery bypass graft                               A  26.08  10.81NA   9.72NA  10.81     9.72     5.57  42.46  41.37  42.46  41.37  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35654  Artery bypass graft                               A  26.28  11.38NA  11.35NA  11.38    11.35     6.06  43.72  43.69  43.72  43.69  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35656  Artery bypass graft                               A  20.47   9.27NA   9.27NA   9.27     9.27     4.70  34.44  34.44  34.44  34.44  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35661  Artery bypass graft                               A  20.35   9.55NA   9.51NA   9.55     9.51     4.69  34.59  34.55  34.59  34.55  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35663  Artery bypass graft                               A  23.93  10.49NA  10.28NA  10.49    10.28     5.46  39.88  39.67  39.88  39.67  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35665  Artery bypass graft                               A  22.35   9.95NA   9.86NA   9.95     9.86     5.11  37.41  37.32  37.41  37.32  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35666  Artery bypass graft                               A  23.66  11.36NA  11.29NA  11.36    11.29     5.43  40.45  40.38  40.45  40.38  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35671  Artery bypass graft                               A  20.77  10.10NA  10.00NA  10.10    10.00     4.77  35.64  35.54  35.64  35.54  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35681  Composite bypass graft                            A   1.60   0.56NA   0.56NA   0.56     0.56     0.37   2.53   2.53   2.53   2.53  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
35682  Composite bypass graft                            A   7.19   2.42NA   2.38NA   2.42     2.38     1.66  11.27  11.23  11.27  11.23  0ZZZ.00.00.0000010             25.5217 090 99      0.00   0.00   0.00
35683  Composite bypass graft                            A   8.49   2.71NA   2.53NA   2.71     2.53     2.00  13.20  13.02  13.20  13.02  0ZZZ.00.00.0000010             25.5217 090 99      0.00   0.00   0.00
35685  Bypass graft patency/patch                        A   4.04   1.38NA   1.38NA   1.38     1.38     0.92   6.34   6.34   6.34   6.34  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
35686  Bypass graft/av fist patency                      A   3.34   1.17NA   1.13NA   1.17     1.13     0.75   5.26   5.22   5.26   5.22  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
35691  Arterial transposition                            A  18.41   7.97NA   7.25NA   7.97     7.25     4.36  30.74  30.02  30.74  30.02  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35693  Arterial transposition                            A  15.73   7.78NA   7.04NA   7.78     7.04     3.73  27.24  26.50  27.24  26.50  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35694  Arterial transposition                            A  19.28   8.62NA   8.56NA   8.62     8.56     4.56  32.46  32.40  32.46  32.40  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35695  Arterial transposition                            A  20.06   8.42NA   7.75NA   8.42     7.75     4.75  33.23  32.56  33.23  32.56  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35697  Reimplant artery each                             A   3.00   1.04NA   1.02NA   1.04     1.02     0.69   4.73   4.71   4.73   4.71  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
3570F  Rprt bone scint xref w xray                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35700  Reoperation bypass graft                          A   3.08   1.08NA   1.07NA   1.08     1.07     0.71   4.87   4.86   4.87   4.86  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
35701  Exploration carotid artery                        A   9.19   6.18NA   6.57NA   6.18     6.57     1.79  17.16  17.55  17.16  17.55  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3572F  Pt consid poss risk fx                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35721  Exploration femoral artery                        A   7.72   4.84NA   4.74NA   4.84     4.74     1.74  14.30  14.20  14.30  14.20  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
3573F  Pt not consid poss risk fx                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
35741  Exploration popliteal artery                      A   8.69   5.23NA   5.32NA   5.23     5.32     1.93  15.85  15.94  15.85  15.94  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35761  Exploration of artery/vein                        A   5.93   4.67NA   4.83NA   4.67     4.83     1.29  11.89  12.05  11.89  12.05  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35800  Explore neck vessels                              A   8.07   5.40NA   5.59NA   5.40     5.59     1.70  15.17  15.36  15.17  15.36  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35820  Explore chest vessels                             A  36.89  15.52NA  16.03NA  15.52    16.03     8.81  61.22  61.73  61.22  61.73  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35840  Explore abdominal vessels                         A  10.96   6.49NA   6.77NA   6.49     6.77     2.35  19.80  20.08  19.80  20.08  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35860  Explore limb vessels                              A   6.80   4.45NA   4.44NA   4.45     4.44     1.55  12.80  12.79  12.80  12.79  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35870  Repair vessel graft defect                        A  24.50  12.32NA  13.85NA  12.32    13.85     5.80  42.62  44.15  42.62  44.15  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35875  Removal of clot in graft                          A  10.72   5.71NA   5.73NA   5.71     5.73     2.43  18.86  18.88  18.86  18.88  0090.09.84.0720110             25.5217 090 99      0.00   0.00   0.00
35876  Removal of clot in graft                          A  17.82   8.12NA   8.14NA   8.12     8.14     4.07  30.01  30.03  30.01  30.03  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35879  Revise graft w/vein                               A  17.41   8.08NA   8.07NA   8.08     8.07     4.01  29.50  29.49  29.50  29.49  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35881  Revise graft w/vein                               A  19.35   8.82NA   8.69NA   8.82     8.69     4.48  32.65  32.52  32.65  32.52  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35883  Revise graft w/nonauto graft                      A  23.15   9.75NA  10.03NA   9.75    10.03     5.32  38.22  38.50  38.22  38.50  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35884  Revise graft w/vein                               A  24.65   9.30NA   8.97NA   9.30     8.97     5.83  39.78  39.45  39.78  39.45  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
35901  Excision graft neck                               A   8.38   5.62NA   5.61NA   5.62     5.61     1.90  15.90  15.89  15.90  15.89  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35903  Excision graft extremity                          A   9.53   6.20NA   6.17NA   6.20     6.17     2.15  17.88  17.85  17.88  17.85  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35905  Excision graft thorax                             A  33.52  12.98NA  11.94NA  12.98    11.94     7.94  54.44  53.40  54.44  53.40  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
35907  Excision graft abdomen                            A  37.27  15.13NA  15.24NA  15.13    15.24     8.57  60.97  61.08  60.97  61.08  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
36000  Place needle in vein                              A   0.18   0.54     0.49     0.08     0.08     0.03   0.75   0.70   0.29   0.29  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36002  Pseudoaneurysm injection trt                      A   1.96   2.71     2.45     1.04     0.95     0.30   4.97   4.71   3.30   3.21  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36005  Injection ext venography                          A   0.95   9.23     8.58     0.40     0.35     0.14  10.32   9.67   1.49   1.44  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
36010  Place catheter in vein                            A   2.43  13.98    12.00     0.96     0.88     0.35  16.76  14.78   3.74   3.66  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36011  Place catheter in vein                            A   3.14  23.92    21.61     1.25     1.18     0.43  27.49  25.18   4.82   4.75  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36012  Place catheter in vein                            A   3.51  22.64    21.25     1.45     1.30     0.52  26.67  25.28   5.48   5.33  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36013  Place catheter in artery                          A   2.52  21.31    19.58     1.01     0.95     0.45  24.28  22.55   3.98   3.92  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36014  Place catheter in artery                          A   3.02  22.10    20.58     1.28     1.12     0.33  25.45  23.93   4.63   4.47  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36015  Place catheter in artery                          A   3.51  23.78    21.91     1.47     1.30     0.37  27.66  25.79   5.35   5.18  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36100  Establish access to artery                        A   3.02  12.19    10.84     1.29     1.14     0.67  15.88  14.53   4.98   4.83  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36120  Establish access to artery                        A   2.01  11.15    10.43     0.76     0.72     0.33  13.49  12.77   3.10   3.06  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36140  Establish access to artery                        A   2.01  12.00    10.65     0.81     0.73     0.39  14.40  13.05   3.21   3.13  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36147  Access av dial grft for eval                      A   3.72  20.20    20.20     1.43     1.43     0.50  24.42  24.42   5.65   5.65  0XXX.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
36148  Access av dial grft for proc                      A   1.00   6.57     6.57     0.37     0.37     0.12   7.69   7.69   1.49   1.49  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
36160  Establish access to aorta                         A   2.52  12.70    11.15     1.06     0.90     0.38  15.60  14.05   3.96   3.80  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36200  Place catheter in aorta                           A   3.02  15.87    14.31     1.18     1.07     0.60  19.49  17.93   4.80   4.69  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36215  Place catheter in artery                          A   4.67  29.12    26.62     2.06     1.81     0.81  34.60  32.10   7.54   7.29  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36216  Place catheter in artery                          A   5.27  31.88    29.41     2.34     2.09     0.92  38.07  35.60   8.53   8.28  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36217  Place catheter in artery                          A   6.29  54.84    50.83     2.80     2.54     1.06  62.19  58.18  10.15   9.89  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36218  Place catheter in artery                          A   1.01   4.59     4.18     0.44     0.41     0.16   5.76   5.35   1.61   1.58  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36245  Place catheter in artery                          A   4.67  30.98    26.55     2.15     1.79     0.87  36.52  32.09   7.69   7.33  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36246  Place catheter in artery                          A   5.27  30.63    27.34     2.22     1.93     0.98  36.88  33.59   8.47   8.18  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36247  Place catheter in artery                          A   6.29  50.53    45.26     2.62     2.29     1.18  58.00  52.73  10.09   9.76  0XXX.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36248  Place catheter in artery                          A   1.01   3.66     3.21     0.42     0.36     0.16   4.83   4.38   1.59   1.53  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36260  Insertion of infusion pump                        A   9.91   6.55NA   7.20NA   6.55     7.20     2.12  18.58  19.23  18.58  19.23  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
36261  Revision of infusion pump                         A   5.63   4.61NA   5.01NA   4.61     5.01     1.33  11.57  11.97  11.57  11.97  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
36262  Removal of infusion pump                          A   4.11   3.74NA   4.07NA   3.74     4.07     0.87   8.72   9.05   8.72   9.05  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
36299  Vessel injection procedure                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
36400  Bl draw < 3 yrs fem/jugular                       A   0.38   0.43     0.52     0.09     0.08     0.05   0.86   0.95   0.52   0.51  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36405  Bl draw < 3 yrs scalp vein                        A   0.31   0.36     0.35     0.12     0.13     0.05   0.72   0.71   0.48   0.49  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36406  Bl draw < 3 yrs other vein                        A   0.18   0.30     0.28     0.07     0.07     0.03   0.51   0.49   0.28   0.28  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36410  Non-routine bl draw > 3 yrs                       A   0.18   0.33     0.27     0.07     0.08     0.03   0.54   0.48   0.28   0.29  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36415  Routine venipuncture                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
36416  Capillary blood draw                              B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
36420  Vein access cutdown < 1 yr                        A   1.01   0.27NA   0.24NA   0.27     0.24     0.12   1.40   1.37   1.40   1.37  0XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
36425  Vein access cutdown > 1 yr                        A   0.76   0.31NA   0.34NA   0.31     0.34     0.11   1.18   1.21   1.18   1.21  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36430  Blood transfusion service                         A   0.00   1.03     0.90     1.03NA   0.90 NA  0.01   1.04   0.91   1.04   0.91  5XXX.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36440  Bl push transfuse 2 yr or <                       A   1.03   0.43NA   0.50NA   0.43     0.50     0.24   1.70   1.77   1.70   1.77  0XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
36450  Bl exchange/transfuse nb                          A   2.23   1.04NA   1.09NA   1.04     1.09     0.11   3.38   3.43   3.38   3.43  0XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
36455  Bl exchange/transfuse non-nb                      A   2.43   0.99NA   0.85NA   0.99     0.85     0.14   3.56   3.42   3.56   3.42  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36460  Transfusion service fetal                         A   6.58   2.72NA   3.07NA   2.72     3.07     1.40  10.70  11.05  10.70  11.05  0XXX.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
36468  Injection(s) spider veins                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
36469  Injection(s) spider veins                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
36470  Injection therapy of vein                         A   1.10   2.95     2.92     0.83     0.85     0.22   4.27   4.24   2.15   2.17  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
36471  Injection therapy of veins                        A   1.65   3.28     3.23     1.08     1.10     0.33   5.26   5.21   3.06   3.08  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
36475  Endovenous rf 1st vein                            A   6.72  46.52    43.94     2.74     2.78     1.41  54.65  52.07  10.87  10.91  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36476  Endovenous rf vein add-on                         A   3.38   7.83     7.60     1.22     1.24     0.72  11.93  11.70   5.32   5.34  0ZZZ.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
36478  Endovenous laser 1st vein                         A   6.72  35.16    31.43     2.77     2.73     1.32  43.20  39.47  10.81  10.77  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
36479  Endovenous laser vein addon                       A   3.38   8.25     7.81     1.26     1.29     0.65  12.28  11.84   5.29   5.32  0ZZZ.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
36481  Insertion of catheter vein                        A   6.98  29.60    53.67     3.01     3.01     0.88  37.46  61.53  10.87  10.87  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
3650F  Eeg ordered rvwd reqstd                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
36500  Insertion of catheter vein                        A   3.51   1.49NA   1.36NA   1.49     1.36     0.53   5.53   5.40   5.53   5.40  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36510  Insertion of catheter vein                        A   1.09   1.82     1.52     0.50     0.53     0.24   3.15   2.85   1.83   1.86  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
36511  Apheresis wbc                                     A   1.74   0.83NA   0.89NA   0.83     0.89     0.27   2.84   2.90   2.84   2.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36512  Apheresis rbc                                     A   1.74   0.84NA   0.88NA   0.84     0.88     0.16   2.74   2.78   2.74   2.78  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36513  Apheresis platelets                               A   1.74   0.91NA   0.98NA   0.91     0.98     0.34   2.99   3.06   2.99   3.06  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36514  Apheresis plasma                                  A   1.74  13.39    12.18     0.77     0.80     0.27  15.40  14.19   2.78   2.81  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36515  Apheresis adsorp/reinfuse                         A   1.74  55.40    50.32     0.78     0.88     0.24  57.38  52.30   2.76   2.86  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36516  Apheresis selective                               A   1.22  61.86    54.37     0.53     0.56     0.35  63.43  55.94   2.10   2.13  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36522  Photopheresis                                     A   1.67  38.52    34.95     1.20     1.20     0.16  40.35  36.78   3.03   3.03  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36555  Insert non-tunnel cv cath                         A   2.68   5.09     4.68     0.74     0.67     0.22   7.99   7.58   3.64   3.57  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36556  Insert non-tunnel cv cath                         A   2.50   4.14     3.93     0.81     0.85     0.31   6.95   6.74   3.62   3.66  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36557  Insert tunneled cv cath                           A   5.14  21.68    22.72     3.38     3.60     1.09  27.91  28.95   9.61   9.83  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
36558  Insert tunneled cv cath                           A   4.84  18.46    16.89     2.95     2.81     0.72  24.02  22.45   8.51   8.37  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
36560  Insert tunneled cv cath                           A   6.29  30.73    32.00     3.83     4.11     0.58  37.60  38.87  10.70  10.98  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
36561  Insert tunneled cv cath                           A   6.04  28.07    26.85     3.54     3.60     1.10  35.21  33.99  10.68  10.74  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
36563  Insert tunneled cv cath                           A   6.24  29.88    30.48     3.66     3.88     1.30  37.42  38.02  11.20  11.42  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
36565  Insert tunneled cv cath                           A   6.04  22.57    21.59     3.32     3.35     1.29  29.90  28.92  10.65  10.68  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
36566  Insert tunneled cv cath                           A   6.54 125.28   141.04     3.59     3.72     1.26 133.08 148.84  11.39  11.52  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
36568  Insert picc cath                                  A   1.92   6.76     5.88     0.77     0.75     0.18   8.86   7.98   2.87   2.85  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36569  Insert picc cath                                  A   1.82   5.68     4.97     0.79     0.74     0.18   7.68   6.97   2.79   2.74  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36570  Insert picvad cath                                A   5.36  27.68    24.28     3.22     3.00     0.49  33.53  30.13   9.07   8.85  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
36571  Insert picvad cath                                A   5.34  31.51    30.41     3.26     3.35     1.02  37.87  36.77   9.62   9.71  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
36575  Repair tunneled cv cath                           A   0.67   4.06     3.86     0.30     0.30     0.10   4.83   4.63   1.07   1.07  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
36576  Repair tunneled cv cath                           A   3.24   7.35     7.14     2.06     2.06     0.56  11.15  10.94   5.86   5.86  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
36578  Replace tunneled cv cath                          A   3.54  11.18    10.52     2.48     2.38     0.53  15.25  14.59   6.55   6.45  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
36580  Replace cvad cath                                 A   1.31   5.18     4.59     0.55     0.54     0.16   6.65   6.06   2.02   2.01  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36581  Replace tunneled cv cath                          A   3.48  18.90    17.59     2.13     1.97     0.43  22.81  21.50   6.04   5.88  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
36582  Replace tunneled cv cath                          A   5.24  26.68    25.57     3.18     3.12     0.88  32.80  31.69   9.30   9.24  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
36583  Replace tunneled cv cath                          A   5.29  30.14    32.42     3.44     3.68     1.14  36.57  38.85   9.87  10.11  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
36584  Replace picc cath                                 A   1.20   5.08     4.36     0.72     0.66     0.11   6.39   5.67   2.03   1.97  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36585  Replace picvad cath                               A   4.84  27.46    25.72     3.01     2.87     0.67  32.97  31.23   8.52   8.38  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
36589  Removal tunneled cv cath                          A   2.28   2.36     2.28     1.58     1.55     0.37   5.01   4.93   4.23   4.20  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
36590  Removal tunneled cv cath                          A   3.35   4.54     4.67     2.15     2.22     0.62   8.51   8.64   6.12   6.19  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
36591  Draw blood off venous device                      T   0.00   0.67     0.61     0.67NA   0.61 NA  0.01   0.68   0.62   0.68   0.62  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
36592  Collect blood from picc                           T   0.00   0.75     0.69     0.75NA   0.69 NA  0.01   0.76   0.70   0.76   0.70  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
36593  Declot vascular device                            A   0.00   0.85     0.82     0.85NA   0.82 NA  0.01   0.86   0.83   0.86   0.83  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
36595  Mech remov tunneled cv cath                       A   3.59  13.58    11.92     1.69     1.53     0.39  17.56  15.90   5.67   5.51  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36596  Mech remov tunneled cv cath                       A   0.75   3.19     2.89     0.52     0.48     0.10   4.04   3.74   1.37   1.33  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36597  Reposition venous catheter                        A   1.21   2.42     2.21     0.54     0.49     0.11   3.74   3.53   1.86   1.81  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36598  Inj w/fluor eval cv device                        T   0.74   2.56     2.32     0.67     0.27     0.07   3.37   3.13   1.48   1.08  9000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
36600  Withdrawal of arterial blood                      A   0.32   0.56     0.53     0.11     0.11     0.03   0.91   0.88   0.46   0.46  0XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36620  Insertion catheter artery                         A   1.15   0.25NA   0.29NA   0.25     0.29     0.10   1.50   1.54   1.50   1.54  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36625  Insertion catheter artery                         A   2.11   0.70NA   0.71NA   0.70     0.71     0.42   3.23   3.24   3.23   3.24  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
36640  Insertion catheter artery                         A   2.10   1.29NA   1.40NA   1.29     1.40     0.42   3.81   3.92   3.81   3.92  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36660  Insertion catheter artery                         A   1.40   0.54NA   0.68NA   0.54     0.68     0.34   2.28   2.42   2.28   2.42  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
36680  Insert needle bone cavity                         A   1.20   0.37NA   0.35NA   0.37     0.35     0.22   1.79   1.77   1.79   1.77  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
36800  Insertion of cannula                              A   2.43   2.01NA   2.02NA   2.01     2.02     0.42   4.86   4.87   4.86   4.87  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36810  Insertion of cannula                              A   3.96   1.75NA   1.80NA   1.75     1.80     0.73   6.44   6.49   6.44   6.49  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36815  Insertion of cannula                              A   2.62   1.43NA   1.46NA   1.43     1.46     0.56   4.61   4.64   4.61   4.64  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36818  Av fuse uppr arm cephalic                         A  11.89   6.28NA   6.37NA   6.28     6.37     2.65  20.82  20.91  20.82  20.91  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
36819  Av fuse uppr arm basilic                          A  14.47   7.08NA   7.23NA   7.08     7.23     3.25  24.80  24.95  24.80  24.95  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
36820  Av fusion/forearm vein                            A  14.47   7.27NA   7.52NA   7.27     7.52     3.23  24.97  25.22  24.97  25.22  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
36821  Av fusion direct any site                         A  12.11   6.45NA   6.79NA   6.45     6.79     2.70  21.26  21.60  21.26  21.60  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
36822  Insertion of cannula(s)                           A   5.57   4.81NA   4.71NA   4.81     4.71     1.29  11.67  11.57  11.67  11.57  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
36823  Insertion of cannula(s)                           A  22.98  11.96NA  12.46NA  11.96    12.46     5.00  39.94  40.44  39.94  40.44  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
36825  Artery-vein autograft                             A  15.13   6.73NA   7.83NA   6.73     7.83     3.37  25.23  26.33  25.23  26.33  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
36830  Artery-vein nonautograft                          A  12.03   5.70NA   5.80NA   5.70     5.80     2.70  20.43  20.53  20.43  20.53  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
36831  Open thrombect av fistula                         A   8.04   4.36NA   4.45NA   4.36     4.45     1.79  14.19  14.28  14.19  14.28  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
36832  Av fistula revision open                          A  10.53   5.17NA   5.28NA   5.17     5.28     2.34  18.04  18.15  18.04  18.15  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
36833  Av fistula revision                               A  11.98   5.72NA   5.85NA   5.72     5.85     2.69  20.39  20.52  20.39  20.52  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
36835  Artery to vein shunt                              A   7.51   5.53NA   5.94NA   5.53     5.94     1.78  14.82  15.23  14.82  15.23  0090.09.84.0720100             25.5217 090 99      0.00   0.00   0.00
36838  Dist revas ligation hemo                          A  21.69   9.55NA   9.47NA   9.55     9.47     4.93  36.17  36.09  36.17  36.09  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
36860  External cannula declotting                       A   2.01   3.73     3.80     0.94     1.05     0.26   6.00   6.07   3.21   3.32  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36861  Cannula declotting                                A   2.52   1.63NA   1.62NA   1.63     1.62     0.48   4.63   4.62   4.63   4.62  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
36870  Percut thrombect av fistula                       A   5.20  49.97    46.44     3.36     3.12     0.68  55.85  52.32   9.24   9.00  0090.09.84.0721120             25.5217 090 99      0.00   0.00   0.00
3700F  Psych disorders assessed                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
37140  Revision of circulation                           A  25.23  12.93NA  14.17NA  12.93    14.17     5.36  43.52  44.76  43.52  44.76  0090.09.84.0720110             25.5217 090 99      0.00   0.00   0.00
37145  Revision of circulation                           A  26.24  13.73NA  14.51NA  13.73    14.51     5.70  45.67  46.45  45.67  46.45  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
37160  Revision of circulation                           A  23.24  12.04NA  13.30NA  12.04    13.30     4.96  40.24  41.50  40.24  41.50  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37180  Revision of circulation                           A  26.24  13.12NA  14.61NA  13.12    14.61     5.59  44.95  46.44  44.95  46.44  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37181  Splice spleen/kidney veins                        A  28.37  14.14NA  15.54NA  14.14    15.54     6.03  48.54  49.94  48.54  49.94  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37182  Insert hepatic shunt (tips)                       A  16.97   7.34NA   6.34NA   7.34     6.34     1.62  25.93  24.93  25.93  24.93  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
37183  Remove hepatic shunt (tips)                       A   7.99 152.24   152.24     3.53     3.01     0.73 160.96 160.96  12.25  11.73  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
37184  Prim art mech thrombectomy                        A   8.66  61.25    54.65     3.91     3.56     1.51  71.42  64.82  14.08  13.73  0000.00.00.0021120             25.5217 090 99      0.00   0.00   0.00
37185  Prim art m-thrombect add-on                       A   3.28  19.69    17.49     1.32     1.20     0.61  23.58  21.38   5.21   5.09  0ZZZ.00.00.0002120             25.5217 090 99      0.00   0.00   0.00
37186  Sec art m-thrombect add-on                        A   4.92  40.61    34.36     2.09     1.81     0.95  46.48  40.23   7.96   7.68  0ZZZ.00.00.0002120             25.5217 090 99      0.00   0.00   0.00
37187  Venous mech thrombectomy                          A   8.03  58.83    52.29     3.58     3.19     1.13  67.99  61.45  12.74  12.35  0000.00.00.0021120             25.5217 090 99      0.00   0.00   0.00
37188  Venous m-thrombectomy add-on                      A   5.71  50.94    44.92     2.70     2.39     0.69  57.34  51.32   9.10   8.79  0000.00.00.0021120             25.5217 090 99      0.00   0.00   0.00
37195  Thrombolytic therapy stroke                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
3720F  Cognit impairment assessed                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
37200  Transcatheter biopsy                              A   4.55   1.90NA   1.64NA   1.90     1.64     0.42   6.87   6.61   6.87   6.61  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
37201  Transcatheter therapy infuse                      A   4.99   2.76NA   2.49NA   2.76     2.49     0.76   8.51   8.24   8.51   8.24  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
37202  Transcatheter therapy infuse                      A   5.67   3.50NA   2.97NA   3.50     2.97     1.18  10.35   9.82  10.35   9.82  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
37203  Transcatheter retrieval                           A   5.02  34.51    31.63     2.37     2.08     0.68  40.21  37.33   8.07   7.78  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
37204  Transcatheter occlusion                           A  18.11   7.35NA   6.52NA   7.35     6.52     2.21  27.67  26.84  27.67  26.84  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
37205  Transcath iv stent percut                         A   8.27 118.66   108.43     3.64     3.05     1.56 128.49 118.26  13.47  12.88  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
37206  Transcath iv stent/perc addl                      A   4.12  72.34    65.91     1.71     1.49     0.81  77.27  70.84   6.64   6.42  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
37207  Transcath iv stent open                           A   8.27   3.27NA   3.23NA   3.27     3.23     1.86  13.40  13.36  13.40  13.36  0000.00.00.0021220             25.5217 090 99      0.00   0.00   0.00
37208  Transcath iv stent/open addl                      A   4.12   1.43NA   1.42NA   1.43     1.42     0.92   6.47   6.46   6.47   6.46  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
37209  Change iv cath at thromb tx                       A   2.27   0.90NA   0.80NA   0.90     0.80     0.33   3.50   3.40   3.50   3.40  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
37210  Embolization uterine fibroid                      A  10.60  95.23    88.63     4.68     4.00     1.02 106.85 100.25  16.30  15.62  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
37215  Transcath stent cca w/eps                         R  19.68  10.51NA   8.94NA  10.51     8.94     4.18  34.37  32.80  34.37  32.80  0090.09.84.0720000             25.5217 090 99      0.00   0.00   0.00
37216  Transcath stent cca w/o eps                       N+ 18.95  10.04NA  10.10NA  10.04    10.10     1.33  30.32  30.38  30.32  30.38  9090.09.84.0799999             25.5217 090 99      0.00   0.00   0.00
37220  Iliac revasc                                      A   8.15  83.88    83.88     3.03     3.03     1.67  93.70  93.70  12.85  12.85  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
37221  Iliac revasc w/stent                              A  10.00 126.56   126.56     3.75     3.75     1.89 138.45 138.45  15.64  15.64  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
37222  Iliac revasc add-on                               A   3.73  22.52    22.52     1.34     1.34     0.76  27.01  27.01   5.83   5.83  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
37223  Iliac revasc w/stent add-on                       A   4.25 132.39   132.39     1.53     1.53     0.84 137.48 137.48   6.62   6.62  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
37224  Fem/popl revas w/tla                              A   9.00 101.76   101.76     3.34     3.34     1.81 112.57 112.57  14.15  14.15  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
37225  Fem/popl revas w/ather                            A  12.00 303.34   303.34     4.55     4.55     2.51 317.85 317.85  19.06  19.06  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
37226  Fem/popl revasc w/stent                           A  10.49 254.28   254.28     3.93     3.93     1.29 266.06 266.06  15.71  15.71  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
37227  Fem/popl revasc stnt & ather                      A  14.50 412.19   412.19     5.48     5.48     3.04 429.73 429.73  23.02  23.02  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
37228  Tib/per revasc w/tla                              A  11.00 146.98   146.98     4.04     4.04     2.25 160.23 160.23  17.29  17.29  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
37229  Tib/per revasc w/ather                            A  14.05 298.12   298.12     5.30     5.30     2.97 315.14 315.14  22.32  22.32  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
37230  Tib/per revasc w/stent                            A  13.80 231.18   231.18     5.13     5.13     2.61 247.59 247.59  21.54  21.54  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
37231  Tib/per revasc stent & ather                      A  15.00 379.46   379.46     5.57     5.57     2.84 397.30 397.30  23.41  23.41  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
37232  Tib/per revasc add-on                             A   4.00  31.17    31.17     1.43     1.43     0.81  35.98  35.98   6.24   6.24  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
37233  Tibper revasc w/ather add-on                      A   6.50  36.11    36.11     2.41     2.41     1.37  43.98  43.98  10.28  10.28  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
37234  Revsc opn/prq tib/pero stent                      A   5.50 108.02   108.02     1.98     1.98     1.09 114.61 114.61   8.57   8.57  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
37235  Tib/per revasc stnt & ather                       A   7.80 113.10   113.10     2.81     2.81     1.55 122.45 122.45  12.16  12.16  0ZZZ.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
37250  Iv us first vessel add-on                         A   2.10   0.85NA   0.74NA   0.85     0.74     0.45   3.40   3.29   3.40   3.29  0ZZZ.00.00.0000010             25.5217 090 99      0.00   0.00   0.00
37251  Iv us each add vessel add-on                      A   1.60   0.58NA   0.53NA   0.58     0.53     0.35   2.53   2.48   2.53   2.48  0ZZZ.00.00.0000010             25.5217 090 99      0.00   0.00   0.00
37500  Endoscopy ligate perf veins                       A  11.67   7.18NA   7.15NA   7.18     7.15     2.62  21.47  21.44  21.47  21.44  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
37501  Vascular endoscopy procedure                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021110             25.5217 090 99      0.00   0.00   0.00
37565  Ligation of neck vein                             A  12.05   7.19NA   7.67NA   7.19     7.67     2.57  21.81  22.29  21.81  22.29  0090.09.84.0720010             25.5217 090 99      0.00   0.00   0.00
37600  Ligation of neck artery                           A  12.42   6.91NA   7.14NA   6.91     7.14     2.54  21.87  22.10  21.87  22.10  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37605  Ligation of neck artery                           A  14.28   7.39NA   7.54NA   7.39     7.54     3.38  25.05  25.20  25.05  25.20  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37606  Ligation of neck artery                           A   8.81   4.88NA   4.33NA   4.88     4.33     1.87  15.56  15.01  15.56  15.01  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
37607  Ligation of a-v fistula                           A   6.25   4.03NA   4.10NA   4.03     4.10     1.37  11.65  11.72  11.65  11.72  0090.09.84.0720110             25.5217 090 99      0.00   0.00   0.00
37609  Temporal artery procedure                         A   3.05   5.44     5.62     2.50     2.67     0.64   9.13   9.31   6.19   6.36  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
37615  Ligation of neck artery                           A   7.80   6.09NA   6.99NA   6.09     6.99     1.64  15.53  16.43  15.53  16.43  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37616  Ligation of chest artery                          A  18.97  10.30NA  10.40NA  10.30    10.40     4.05  33.32  33.42  33.32  33.42  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37617  Ligation of abdomen artery                        A  23.79  11.10NA  11.75NA  11.10    11.75     5.01  39.90  40.55  39.90  40.55  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37618  Ligation of extremity artery                      A   6.03   4.40NA   4.52NA   4.40     4.52     1.32  11.75  11.87  11.75  11.87  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37620  Revision of major vein                            A  11.57   6.55NA   6.01NA   6.55     6.01     1.70  19.82  19.28  19.82  19.28  0090.09.84.0720110             25.5217 090 99      0.00   0.00   0.00
37650  Revision of major vein                            A   8.49   4.74NA   4.08NA   4.74     4.08     1.87  15.10  14.44  15.10  14.44  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
37660  Revision of major vein                            A  22.28  11.15NA  12.25NA  11.15    12.25     4.74  38.17  39.27  38.17  39.27  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37700  Revise leg vein                                   A   3.82   3.13NA   3.16NA   3.13     3.16     0.84   7.79   7.82   7.79   7.82  0090.09.84.0721100             25.5217 090 99      0.00   0.00   0.00
37718  Ligate/strip short leg vein                       A   7.13   4.75NA   4.86NA   4.75     4.86     1.56  13.44  13.55  13.44  13.55  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
37722  Ligate/strip long leg vein                        A   8.16   5.00NA   5.13NA   5.00     5.13     1.81  14.97  15.10  14.97  15.10  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
37735  Removal of leg veins/lesion                       A  10.90   6.14NA   6.16NA   6.14     6.16     2.39  19.43  19.45  19.43  19.45  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
37760  Ligate leg veins radical                          A  10.78   6.74NA   7.47NA   6.74     7.47     2.28  19.80  20.53  19.80  20.53  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
37761  Ligate leg veins open                             A   9.13   6.21NA   6.21NA   6.21     6.21     1.96  17.30  17.30  17.30  17.30  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
37765  Stab phleb veins xtr 10-20                        A   7.71  10.69    10.69     4.75     4.68     1.56  19.96  19.96  14.02  13.95  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
37766  Phleb veins - extrem 20+                          A   9.66  12.11    12.11     5.51     5.44     2.01  23.78  23.78  17.18  17.11  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
37780  Revision of leg vein                              A   3.93   3.24NA   3.25NA   3.24     3.25     0.86   8.03   8.04   8.03   8.04  0090.09.84.0721110             25.5217 090 99      0.00   0.00   0.00
37785  Ligate/divide/excise vein                         A   3.93   6.04     5.98     3.25     3.27     0.86  10.83  10.77   8.04   8.06  0090.09.84.0721100             25.5217 090 99      0.00   0.00   0.00
37788  Revascularization penis                           A  23.33  13.74NA  12.86NA  13.74    12.86     4.97  42.04  41.16  42.04  41.16  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
37790  Penile venous occlusion                           A   8.43   5.28NA   5.02NA   5.28     5.02     0.81  14.52  14.26  14.52  14.26  0090.08.83.0920000             25.5217 090 99      0.00   0.00   0.00
37799  Vascular surgery procedure                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
38100  Removal of spleen total                           A  19.55   9.67NA  10.78NA   9.67    10.78     4.07  33.29  34.40  33.29  34.40  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38101  Removal of spleen partial                         A  19.55   9.85NA  11.07NA   9.85    11.07     4.16  33.56  34.78  33.56  34.78  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38102  Removal of spleen total                           A   4.79   1.91NA   2.09NA   1.91     2.09     0.99   7.69   7.87   7.69   7.87  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
38115  Repair of ruptured spleen                         A  21.88  10.60NA  11.83NA  10.60    11.83     4.28  36.76  37.99  36.76  37.99  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38120  Laparoscopy splenectomy                           A  17.07   9.82NA  10.74NA   9.82    10.74     3.60  30.49  31.41  30.49  31.41  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
38129  Laparoscope proc spleen                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
38200  Injection for spleen x-ray                        A   2.64   1.18NA   1.15NA   1.18     1.15     0.62   4.44   4.41   4.44   4.41  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
38204  Bl donor search management                        B+  2.00   0.85NA   0.88NA   0.85     0.88     0.14   2.99   3.02   2.99   3.02  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38205  Harvest allogenic stem cells                      R   1.50   0.77NA   0.81NA   0.77     0.81     0.08   2.35   2.39   2.35   2.39  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
38206  Harvest auto stem cells                           R   1.50   0.78NA   0.82NA   0.78     0.82     0.11   2.39   2.43   2.39   2.43  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
38207  Cryopreserve stem cells                           I+  0.89   0.47NA   0.39NA   0.47     0.39     0.05   1.41   1.33   1.41   1.33  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38208  Thaw preserved stem cells                         I+  0.56   0.29NA   0.25NA   0.29     0.25     0.04   0.89   0.85   0.89   0.85  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38209  Wash harvest stem cells                           I+  0.24   0.13NA   0.11NA   0.13     0.11     0.01   0.38   0.36   0.38   0.36  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38210  T-cell depletion of harvest                       I+  1.57   0.82NA   0.69NA   0.82     0.69     0.10   2.49   2.36   2.49   2.36  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38211  Tumor cell deplete of harvst                      I+  1.42   0.75NA   0.63NA   0.75     0.63     0.10   2.27   2.15   2.27   2.15  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38212  Rbc depletion of harvest                          I+  0.94   0.49NA   0.41NA   0.49     0.41     0.05   1.48   1.40   1.48   1.40  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38213  Platelet deplete of harvest                       I+  0.24   0.13NA   0.11NA   0.13     0.11     0.01   0.38   0.36   0.38   0.36  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38214  Volume deplete of harvest                         I+  0.81   0.42NA   0.36NA   0.42     0.36     0.05   1.28   1.22   1.28   1.22  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38215  Harvest stem cell concentrte                      I+  0.94   0.49NA   0.41NA   0.49     0.41     0.05   1.48   1.40   1.48   1.40  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
38220  Bone marrow aspiration                            A   1.08   3.28     2.94     0.62     0.63     0.11   4.47   4.13   1.81   1.82  0XXX.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
38221  Bone marrow biopsy                                A   1.37   3.37     2.96     0.78     0.79     0.08   4.82   4.41   2.23   2.24  0XXX.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
38230  Bone marrow collection                            R   4.85   4.17NA   4.45NA   4.17     4.45     1.10  10.12  10.40  10.12  10.40  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
38240  Bone marrow/stem transplant                       R   2.24   1.30NA   1.35NA   1.30     1.35     0.16   3.70   3.75   3.70   3.75  0XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
38241  Bone marrow/stem transplant                       R   2.24   1.30NA   1.34NA   1.30     1.34     0.14   3.68   3.72   3.68   3.72  0XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
38242  Lymphocyte infuse transplant                      A   1.71   1.00NA   1.06NA   1.00     1.06     0.10   2.81   2.87   2.81   2.87  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
38300  Drainage lymph node lesion                        A   2.36   5.26     5.30     2.62     2.70     0.41   8.03   8.07   5.39   5.47  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
38305  Drainage lymph node lesion                        A   6.68   5.49NA   5.71NA   5.49     5.71     1.33  13.50  13.72  13.50  13.72  0090.11.73.1620100             25.5217 090 99      0.00   0.00   0.00
38308  Incision of lymph channels                        A   6.81   4.83NA   5.17NA   4.83     5.17     1.45  13.09  13.43  13.09  13.43  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38380  Thoracic duct procedure                           A   8.46   7.30NA   8.09NA   7.30     8.09     1.09  16.85  17.64  16.85  17.64  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38381  Thoracic duct procedure                           A  13.38   7.80NA   7.66NA   7.80     7.66     3.14  24.32  24.18  24.32  24.18  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38382  Thoracic duct procedure                           A  10.65   6.96NA   7.08NA   6.96     7.08     2.25  19.86  19.98  19.86  19.98  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38500  Biopsy/removal lymph nodes                        A   3.79   4.88     5.15     2.77     2.98     0.77   9.44   9.71   7.33   7.54  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
38505  Needle biopsy lymph nodes                         A   1.14   2.45     2.33     0.89     0.84     0.12   3.71   3.59   2.15   2.10  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
38510  Biopsy/removal lymph nodes                        A   6.74   7.19     7.63     4.42     4.80     1.21  15.14  15.58  12.37  12.75  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
38520  Biopsy/removal lymph nodes                        A   7.03   5.19NA   5.53NA   5.19     5.53     1.41  13.63  13.97  13.63  13.97  0090.11.73.1621100             25.5217 090 99      0.00   0.00   0.00
38525  Biopsy/removal lymph nodes                        A   6.43   4.71NA   5.13NA   4.71     5.13     1.36  12.50  12.92  12.50  12.92  0090.11.73.1621100             25.5217 090 99      0.00   0.00   0.00
38530  Biopsy/removal lymph nodes                        A   8.34   5.80NA   6.27NA   5.80     6.27     1.82  15.96  16.43  15.96  16.43  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38542  Explore deep node(s) neck                         A   7.95   6.03NA   6.52NA   6.03     6.52     1.33  15.31  15.80  15.31  15.80  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38550  Removal neck/armpit lesion                        A   7.11   5.80NA   6.39NA   5.80     6.39     1.52  14.43  15.02  14.43  15.02  0090.11.73.1620000             25.5217 090 99      0.00   0.00   0.00
38555  Removal neck/armpit lesion                        A  15.59  10.46NA  11.12NA  10.46    11.12     3.34  29.39  30.05  29.39  30.05  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38562  Removal pelvic lymph nodes                        A  11.06   7.48NA   7.67NA   7.48     7.67     1.96  20.50  20.69  20.50  20.69  0090.11.73.1622210             25.5217 090 99      0.00   0.00   0.00
38564  Removal abdomen lymph nodes                       A  11.38   6.95NA   7.35NA   6.95     7.35     2.24  20.57  20.97  20.57  20.97  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38570  Laparoscopy lymph node biop                       A   9.34   5.17NA   5.15NA   5.17     5.15     1.37  15.88  15.86  15.88  15.86  0010.10.80.1030220       49320 25.5217 090 99      0.00   0.00   0.00
38571  Laparoscopy lymphadenectomy                       A  14.76   7.81NA   7.08NA   7.81     7.08     1.48  24.05  23.32  24.05  23.32  0010.10.80.1022220             25.5217 090 99      0.00   0.00   0.00
38572  Laparoscopy lymphadenectomy                       A  16.94   8.46NA   8.92NA   8.46     8.92     2.39  27.79  28.25  27.79  28.25  0010.10.80.1022220             25.5217 090 99      0.00   0.00   0.00
38589  Laparoscope proc lymphatic                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
38700  Removal of lymph nodes neck                       A  12.81   9.18NA  10.18NA   9.18    10.18     1.77  23.76  24.76  23.76  24.76  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38720  Removal of lymph nodes neck                       A  21.95  14.35NA  15.95NA  14.35    15.95     3.38  39.68  41.28  39.68  41.28  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38724  Removal of lymph nodes neck                       A  23.95  15.66NA  17.66NA  15.66    17.66     3.34  42.95  44.95  42.95  44.95  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38740  Remove armpit lymph nodes                         A  10.70   6.93NA   7.55NA   6.93     7.55     2.25  19.88  20.50  19.88  20.50  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38745  Remove armpit lymph nodes                         A  13.87   8.46NA   9.25NA   8.46     9.25     2.95  25.28  26.07  25.28  26.07  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38746  Remove thoracic lymph nodes                       A   4.88   1.86NA   1.80NA   1.86     1.80     1.14   7.88   7.82   7.88   7.82  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
38747  Remove abdominal lymph nodes                      A   4.88   1.94NA   2.10NA   1.94     2.10     1.03   7.85   8.01   7.85   8.01  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
38760  Remove groin lymph nodes                          A  13.62   8.16NA   8.73NA   8.16     8.73     2.78  24.56  25.13  24.56  25.13  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38765  Remove groin lymph nodes                          A  21.91  11.64NA  12.34NA  11.64    12.34     4.22  37.77  38.47  37.77  38.47  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38770  Remove pelvis lymph nodes                         A  14.06   8.10NA   7.87NA   8.10     7.87     1.77  23.93  23.70  23.93  23.70  0090.11.73.1621210             25.5217 090 99      0.00   0.00   0.00
38780  Remove abdomen lymph nodes                        A  17.70  10.36NA  10.27NA  10.36    10.27     2.55  30.61  30.52  30.61  30.52  0090.11.73.1620210             25.5217 090 99      0.00   0.00   0.00
38790  Inject for lymphatic x-ray                        A   1.29   0.95NA   0.96NA   0.95     0.96     0.24   2.48   2.49   2.48   2.49  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
38792  Identify sentinel node                            A   0.52   0.59NA   0.59NA   0.59     0.59     0.08   1.19   1.19   1.19   1.19  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
38794  Access thoracic lymph duct                        A   4.62   3.80NA   3.43NA   3.80     3.43     0.42   8.84   8.47   8.84   8.47  0090.11.73.1620000             25.5217 090 99      0.00   0.00   0.00
38900  Io map of sent lymph node                         A   2.50   1.02     1.02     1.02     1.02     0.53   4.05   4.05   4.05   4.05  0ZZZ.00.00.0001210             25.5217 090 99      0.00   0.00   0.00
38999  Blood/lymph system procedure                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
39000  Exploration of chest                              A   7.57   5.70NA   5.80NA   5.70     5.80     1.67  14.94  15.04  14.94  15.04  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39010  Exploration of chest                              A  13.19   7.89NA   7.62NA   7.89     7.62     3.12  24.20  23.93  24.20  23.93  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39200  Removal chest lesion                              A  15.09   8.18NA   8.03NA   8.18     8.03     3.53  26.80  26.65  26.80  26.65  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39220  Removal chest lesion                              A  19.55  10.61NA  10.49NA  10.61    10.49     4.43  34.59  34.47  34.59  34.47  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39400  Visualization of chest                            A   8.05   5.41NA   5.34NA   5.41     5.34     1.87  15.33  15.26  15.33  15.26  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
39499  Chest procedure                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
39501  Repair diaphragm laceration                       A  13.98   8.03NA   8.48NA   8.03     8.48     2.95  24.96  25.41  24.96  25.41  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39503  Repair of diaphragm hernia                        A 108.91  46.00NA  52.18NA  46.00    52.18    23.18 178.09 184.27 178.09 184.27  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39540  Repair of diaphragm hernia                        A  14.57   7.90NA   8.44NA   7.90     8.44     3.11  25.58  26.12  25.58  26.12  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39541  Repair of diaphragm hernia                        A  15.75   8.59NA   9.23NA   8.59     9.23     3.40  27.74  28.38  27.74  28.38  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39545  Revision of diaphragm                             A  14.67   8.86NA   8.78NA   8.86     8.78     3.41  26.94  26.86  26.94  26.86  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39560  Resect diaphragm simple                           A  13.06   7.57NA   7.88NA   7.57     7.88     2.78  23.41  23.72  23.41  23.72  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39561  Resect diaphragm complex                          A  19.99  12.44NA  13.04NA  12.44    13.04     4.37  36.80  37.40  36.80  37.40  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
39599  Diaphragm surgery procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
4000F  Tobacco use txmnt counseling                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4001F  Tobacco use txmnt pharmacol                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4002F  Statin therapy rx                                 M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4003F  Pt ed write/oral pts w/ hf                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4004F  Pt tobacco screen rcvd tlk                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4005F  Pharm thx for op rxd                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4006F  Beta-blocker therapy rx                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4009F  Ace/arb inhibitor therapy rx                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4011F  Oral antiplatelet therapy rx                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4012F  Warfarin therapy rx                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4014F  Written discharge instr prvd                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4015F  Persist asthma medicine ctrl                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4016F  Anti-inflm/anlgsc agent rx                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4017F  Gi prophylaxis for nsaid rx                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4018F  Therapy exercise joint rx                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4019F  Doc recpt counsl vit d/calc+                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4025F  Inhaled bronchodilator rx                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4030F  Oxygen therapy rx                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4033F  Pulmonary rehab rec                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4035F  Influenza imm rec                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4037F  Influenza imm order/admin                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4040F  Pneumoc vac/admin/rcvd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4041F  Doc order cefazolin/cefurox                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4042F  Doc antibio not given                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4043F  Doc order given stop antibio                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4044F  Doc order given vte prophylx                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4045F  Empiric antibiotic rx                             M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4046F  Doc antibio given b/4 surg                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4047F  Doc antibio given b/4 surg                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4048F  Doc antibio given b/4 surg                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4049F  Doc order given stop antibio                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40490  Biopsy of lip                                     A   1.22   2.41     2.40     0.83     0.89     0.18   3.81   3.80   2.23   2.29  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
4050F  Ht care plan doc                                  M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40500  Partial excision of lip                           A   4.47   9.69    10.04     5.68     5.99     0.67  14.83  15.18  10.82  11.13  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
4051F  Referred for an AV fistula                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40510  Partial excision of lip                           A   4.82   8.66     9.02     5.04     5.40     0.71  14.19  14.55  10.57  10.93  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
4052F  Hemodialysis via AV fistula                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40520  Partial excision of lip                           A   4.79   8.96     9.22     5.15     5.49     0.75  14.50  14.76  10.69  11.03  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
40525  Reconstruct lip with flap                         A   7.72   7.54NA   7.99NA   7.54     7.99     1.26  16.52  16.97  16.52  16.97  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
40527  Reconstruct lip with flap                         A   9.32   8.39NA   8.66NA   8.39     8.66     1.20  18.91  19.18  18.91  19.18  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
4053F  Hemodialysis via AV graft                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40530  Partial removal of lip                            A   5.54   9.60     9.90     5.69     6.02     0.86  16.00  16.30  12.09  12.42  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
4054F  Hemodialysis via catheter                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4055F  Pt rcvng periton dialysis                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4056F  Approp oral rehyd recommd                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4058F  Ped gastro ed given caregvr                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4060F  Psych svcs provided                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4062F  Pt referral psych docd                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4063F  Antidepres rxthxpy not rxd                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4064F  Antidepressant rx                                 I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4065F  Antipsychotic rx                                  I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40650  Repair lip                                        A   3.78   7.79     8.04     4.13     4.33     0.65  12.22  12.47   8.56   8.76  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
40652  Repair lip                                        A   4.43   9.06     9.28     5.25     5.52     0.76  14.25  14.47  10.44  10.71  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
40654  Repair lip                                        A   5.48  10.36    10.62     6.24     6.55     0.92  16.76  17.02  12.64  12.95  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
4066F  ECT provided                                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4067F  Pt referral for ect docd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4070F  Dvt prophylx recvd day 2                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40700  Repair cleft lip/nasal                            A  14.17  12.56NA  14.38NA  12.56    14.38     1.82  28.55  30.37  28.55  30.37  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
40701  Repair cleft lip/nasal                            A  17.23  13.59NA  13.91NA  13.59    13.91     2.20  33.02  33.34  33.02  33.34  0090.09.81.1022200             25.5217 090 99      0.00   0.00   0.00
40702  Repair cleft lip/nasal                            A  14.27   9.18NA   9.14NA   9.18     9.14     1.02  24.47  24.43  24.47  24.43  0090.09.81.1022200             25.5217 090 99      0.00   0.00   0.00
40720  Repair cleft lip/nasal                            A  14.72  11.61NA  12.13NA  11.61    12.13     2.91  29.24  29.76  29.24  29.76  0090.09.81.1021000             25.5217 090 99      0.00   0.00   0.00
4073F  Oral antiplat thx rx dischrg                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4075F  Anticoag thx rx at dischrg                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40761  Repair cleft lip/nasal                            A  15.84  13.52NA  14.92NA  13.52    14.92     3.12  32.48  33.88  32.48  33.88  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
4077F  Doc t-pa admin considered                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4079F  Doc rehab svcs considered                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40799  Lip surgery procedure                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
40800  Drainage of mouth lesion                          A   1.23   4.61     4.79     2.41     2.54     0.18   6.02   6.20   3.82   3.95  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
40801  Drainage of mouth lesion                          A   2.63   6.09     6.39     3.52     3.75     0.37   9.09   9.39   6.52   6.75  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
40804  Removal foreign body mouth                        A   1.30   4.71     4.95     2.39     2.51     0.16   6.17   6.41   3.85   3.97  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
40805  Removal foreign body mouth                        A   2.79   6.29     6.57     3.53     3.73     0.35   9.43   9.71   6.67   6.87  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
40806  Incision of lip fold                              A   0.31   2.74     2.72     0.57     0.52     0.04   3.09   3.07   0.92   0.87  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
40808  Biopsy of mouth lesion                            A   1.01   4.26     4.41     2.05     2.14     0.12   5.39   5.54   3.18   3.27  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
40810  Excision of mouth lesion                          A   1.36   4.44     4.63     2.23     2.36     0.18   5.98   6.17   3.77   3.90  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
40812  Excise/repair mouth lesion                        A   2.37   5.63     5.91     3.11     3.34     0.31   8.31   8.59   5.79   6.02  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
40814  Excise/repair mouth lesion                        A   3.52   7.18     7.58     4.98     5.31     0.48  11.18  11.58   8.98   9.31  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
40816  Excision of mouth lesion                          A   3.77   7.47     7.87     5.10     5.42     0.52  11.76  12.16   9.39   9.71  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
40818  Excise oral mucosa for graft                      A   2.83   7.14     7.27     4.82     4.88     0.37  10.34  10.47   8.02   8.08  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
40819  Excise lip or cheek fold                          A   2.51   6.05     6.32     4.06     4.28     0.33   8.89   9.16   6.90   7.12  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
40820  Treatment of mouth lesion                         A   1.34   6.23     6.33     3.58     3.66     0.18   7.75   7.85   5.10   5.18  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
40830  Repair mouth laceration                           A   1.82   5.08     5.29     2.60     2.72     0.31   7.21   7.42   4.73   4.85  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
40831  Repair mouth laceration                           A   2.57   6.60     6.95     3.63     3.78     0.42   9.59   9.94   6.62   6.77  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
4084F  Aspirin recvd w/in 24 hrs                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
40840  Reconstruction of mouth                           R   9.15  14.13    15.74     8.74     9.91     1.18  24.46  26.07  19.07  20.24  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
40842  Reconstruction of mouth                           R   9.15  13.11    14.12     8.31     9.46     1.18  23.44  24.45  18.64  19.79  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
40843  Reconstruction of mouth                           R  12.79  16.01    17.26     9.12    10.06     2.51  31.31  32.56  24.42  25.36  0090.09.81.1022200             25.5217 090 99      0.00   0.00   0.00
40844  Reconstruction of mouth                           R  16.80  21.03    22.39    14.41    16.06     3.31  41.14  42.50  34.52  36.17  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
40845  Reconstruction of mouth                           R  19.36  21.40    22.64    14.84    15.94     2.47  43.23  44.47  36.67  37.77  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
40899  Mouth surgery procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
4090F  Pt rcvng epo thxpy                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4095F  Pt not rcvng epo thxpy                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4100F  Biphos thxpy vein ord/recvd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41000  Drainage of mouth lesion                          A   1.35   3.19     3.33     1.78     1.89     0.18   4.72   4.86   3.31   3.42  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
41005  Drainage of mouth lesion                          A   1.31   5.07     5.10     2.31     2.41     0.16   6.54   6.57   3.78   3.88  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
41006  Drainage of mouth lesion                          A   3.34   6.76     7.09     3.97     4.33     0.42  10.52  10.85   7.73   8.09  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41007  Drainage of mouth lesion                          A   3.20   6.90     7.14     3.78     3.97     0.41  10.51  10.75   7.39   7.58  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41008  Drainage of mouth lesion                          A   3.46   6.98     7.38     4.01     4.32     0.43  10.87  11.27   7.90   8.21  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41009  Drainage of mouth lesion                          A   3.71   7.39     7.83     4.41     4.73     0.48  11.58  12.02   8.60   8.92  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41010  Incision of tongue fold                           A   1.11   4.77     4.91     2.02     2.10     0.14   6.02   6.16   3.27   3.35  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
41015  Drainage of mouth lesion                          A   4.08   8.10     8.80     5.44     5.93     0.52  12.70  13.40  10.04  10.53  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41016  Drainage of mouth lesion                          A   4.19   7.99     8.43     5.55     5.95     0.53  12.71  13.15  10.27  10.67  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41017  Drainage of mouth lesion                          A   4.19   8.09     8.55     5.59     5.98     0.53  12.81  13.27  10.31  10.70  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41018  Drainage of mouth lesion                          A   5.22   8.60     9.04     5.99     6.35     0.67  14.49  14.93  11.88  12.24  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41019  Place needles h&n for rt                          A   8.84   4.31NA   4.28NA   4.31     4.28     0.72  13.87  13.84  13.87  13.84  0000.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
4110F  Int mam art used for cabg                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41100  Biopsy of tongue                                  A   1.42   3.33     3.46     1.63     1.71     0.20   4.95   5.08   3.25   3.33  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
41105  Biopsy of tongue                                  A   1.47   3.33     3.48     1.66     1.78     0.20   5.00   5.15   3.33   3.45  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
41108  Biopsy of floor of mouth                          A   1.10   3.08     3.21     1.45     1.54     0.14   4.32   4.45   2.69   2.78  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
41110  Excision of tongue lesion                         A   1.56   4.45     4.65     2.16     2.29     0.22   6.23   6.43   3.94   4.07  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
41112  Excision of tongue lesion                         A   2.83   6.54     6.86     4.27     4.53     0.37   9.74  10.06   7.47   7.73  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
41113  Excision of tongue lesion                         A   3.29   6.91     7.27     4.54     4.84     0.42  10.62  10.98   8.25   8.55  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
41114  Excision of tongue lesion                         A   8.82   8.94NA   9.65NA   8.94     9.65     1.17  18.93  19.64  18.93  19.64  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41115  Excision of tongue fold                           A   1.79   5.12     5.28     2.42     2.61     0.23   7.14   7.30   4.44   4.63  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
41116  Excision of mouth lesion                          A   2.52   6.77     7.11     3.68     3.89     0.34   9.63   9.97   6.54   6.75  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
41120  Partial removal of tongue                         A  11.14  18.69NA  19.34NA  18.69    19.34     1.48  31.31  31.96  31.31  31.96  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
41130  Partial removal of tongue                         A  15.74  20.92NA  22.06NA  20.92    22.06     2.08  38.74  39.88  38.74  39.88  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
41135  Tongue and neck surgery                           A  30.14  29.90NA  32.02NA  29.90    32.02     4.03  64.07  66.19  64.07  66.19  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
41140  Removal of tongue                                 A  29.15  32.40NA  34.19NA  32.40    34.19     3.75  65.30  67.09  65.30  67.09  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
41145  Tongue removal neck surgery                       A  37.93  39.43NA  42.14NA  39.43    42.14     4.86  82.22  84.93  82.22  84.93  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4115F  Beta blckr admin w/in 24 hrs                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41150  Tongue mouth jaw surgery                          A  29.86  31.27NA  33.20NA  31.27    33.20     3.95  65.08  67.01  65.08  67.01  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
41153  Tongue mouth neck surgery                         A  33.59  32.74NA  35.13NA  32.74    35.13     4.40  70.73  73.12  70.73  73.12  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
41155  Tongue jaw & neck surgery                         A  44.30  38.17NA  41.68NA  38.17    41.68     5.91  88.38  91.89  88.38  91.89  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4120F  Antibiot rxd/given                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4124F  Antibiot not rxd/given                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41250  Repair tongue laceration                          A   1.96   4.76     5.23     2.04     2.26     0.33   7.05   7.52   4.33   4.55  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
41251  Repair tongue laceration                          A   2.32   4.75     5.46     2.29     2.53     0.30   7.37   8.08   4.91   5.15  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
41252  Repair tongue laceration                          A   3.02   5.65     5.99     2.81     3.01     0.48   9.15   9.49   6.31   6.51  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
4130F  Topical prep rx aoe                               M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4131F  Syst antimicrobial thx rx                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4132F  No syst antimicrobial thx rx                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4133F  Antihist/decong rx/recom                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4134F  No antihist/decong rx/recom                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4135F  Systemic corticosteroids rx                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4136F  Syst corticosteroids not rx                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4148F  Hep A vac injxn admin/recvd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4149F  Hep B vac injxn admin/recvd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4150F  Pt recvng antivir txmnt hepc                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41500  Fixation of tongue                                A   3.80   9.08NA   9.40NA   9.08     9.40     0.49  13.37  13.69  13.37  13.69  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
4151F  Pt not recvng antiv hep c                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41510  Tongue to lip surgery                             A   3.51   7.33NA   6.61NA   7.33     6.61     0.43  11.27  10.55  11.27  10.55  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41512  Tongue suspension                                 A   6.86  11.09NA  11.76NA  11.09    11.76     0.49  18.44  19.11  18.44  19.11  0090.10.76.1420000             25.5217 090 99      0.00   0.00   0.00
41520  Reconstruction tongue fold                        A   2.83   6.98     7.28     4.35     4.59     0.35  10.16  10.46   7.53   7.77  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
4153F  Combo pegintf/rib rx                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41530  Tongue base vol reduction                         A   4.51  90.45    91.00     7.24     7.62     0.31  95.27  95.82  12.06  12.44  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
4155F  Hep A vac series prev recvd                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4157F  Hep B vac series prev recvd                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4158F  Pt edu re alcoh drnkng done                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4159F  Contrcp talk b/4 antiv txmnt                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41599  Tongue and mouth surgery                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
4163F  Pt couns 4 txmnt opt prost                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4164F  Adjv hrmnl thxpy rxd                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4165F  3d-crt/imrt received                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4167F  Hd bed tilted 1st day vent                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4168F  Pt care icu&vent w/in 24hrs                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4169F  No pt care ICU/vent in 24hrs                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4171F  Pt rcvng esa thxpy                                M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4172F  Pt not rcvng esa thxpy                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4174F  Couns potent glauc impct                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4175F  Vis of >= 20/40 w/in 90 days                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4176F  Talk re uv light pt/crgvr                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4177F  Talk pt/crgvr re areds prev                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4178F  Antid glbln rcvd w/in 26wks                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4179F  Tamoxifen/AI prescribed                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4180F  Adjv thxpyrxd/rcvd colon ca                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41800  Drainage of gum lesion                            A   1.27   5.69     6.19     2.57     2.81     0.22   7.18   7.68   4.06   4.30  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
41805  Removal foreign body gum                          A   1.34   5.51     5.73     3.44     3.58     0.18   7.03   7.25   4.96   5.10  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
41806  Removal foreign body jawbone                      A   2.79   7.12     7.70     4.45     4.80     0.54  10.45  11.03   7.78   8.13  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
4181F  Conformal radn thxpy rcvd                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4182F  No conformal radn thxpy                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41820  Excision gum each quadrant                        R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
41821  Excision of gum flap                              R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
41822  Excision of gum lesion                            R   2.41   5.67     5.93     2.56     2.89     0.31   8.39   8.65   5.28   5.61  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
41823  Excision of gum lesion                            R   3.77   8.20     8.51     5.23     5.59     0.48  12.45  12.76   9.48   9.84  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41825  Excision of gum lesion                            A   1.41   4.49     4.64     2.09     2.11     0.20   6.10   6.25   3.70   3.72  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
41826  Excision of gum lesion                            A   2.41   6.03     6.59     3.40     3.73     0.31   8.75   9.31   6.12   6.45  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
41827  Excision of gum lesion                            A   3.83   8.34     8.79     4.71     5.08     0.49  12.66  13.11   9.03   9.40  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
41828  Excision of gum lesion                            R   3.14   5.29     5.66     2.76     3.04     0.39   8.82   9.19   6.29   6.57  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
41830  Removal of gum tissue                             R   3.45   7.41     7.82     4.38     4.76     0.43  11.29  11.70   8.26   8.64  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
4185F  Continuous ppi or h2ra rcvd                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41850  Treatment of gum lesion                           R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
4186F  No cont ppi or h2ra rcvd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4187F  Anti rheum drugthxpyrxd/gvn                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41870  Gum graft                                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
41872  Repair gum                                        R   3.01   7.19     7.40     4.32     4.52     0.60  10.80  11.01   7.93   8.13  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
41874  Repair tooth socket                               R   3.19   7.13     7.50     3.88     4.19     0.39  10.71  11.08   7.46   7.77  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
4188F  Approp ACE/ARB tstng done                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4189F  Approp digoxin tstng done                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
41899  Dental surgery procedure                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
4190F  Approp diuretic tstng done                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4191F  Approp anticonvuls tstng                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4192F  Pt not rcvng glucoco thxpy                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4193F  Pt rcvng<10mg daily predniso                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4194F  Pt rcvng>10mg daily predniso                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4195F  Pt rcvng anti-rheum thxpy RA                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4196F  Ptnot rcvng anti-rhm thxpyRA                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4200F  External beam to prost only                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42000  Drainage mouth roof lesion                        A   1.28   3.17     3.26     1.64     1.76     0.16   4.61   4.70   3.08   3.20  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
4201F  Extrnl beam other than prost                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4210F  ACE/ARB thxpy for >= 6 mons                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42100  Biopsy roof of mouth                              A   1.36   2.86     2.99     1.71     1.82     0.18   4.40   4.53   3.25   3.36  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42104  Excision lesion mouth roof                        A   1.69   4.33     4.60     2.20     2.37     0.23   6.25   6.52   4.12   4.29  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42106  Excision lesion mouth roof                        A   2.15   5.42     5.73     2.86     3.02     0.29   7.86   8.17   5.30   5.46  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42107  Excision lesion mouth roof                        A   4.56   8.32     8.78     5.11     5.48     0.58  13.46  13.92  10.25  10.62  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
42120  Remove palate/lesion                              A  11.86  16.05NA  17.06NA  16.05    17.06     1.56  29.47  30.48  29.47  30.48  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42140  Excision of uvula                                 A   1.70   5.55     5.78     2.73     2.86     0.23   7.48   7.71   4.66   4.79  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
42145  Repair palate pharynx/uvula                       A   9.78  10.05NA  10.79NA  10.05    10.79     1.25  21.08  21.82  21.08  21.82  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
42160  Treatment mouth roof lesion                       A   1.85   4.88     4.93     2.38     2.44     0.24   6.97   7.02   4.47   4.53  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
42180  Repair palate                                     A   2.55   4.02     4.01     2.40     2.39     0.33   6.90   6.89   5.28   5.27  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
42182  Repair palate                                     A   3.87   5.23     5.51     3.43     3.61     0.49   9.59   9.87   7.79   7.97  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
4220F  Digoxin thxpy for >= 6 mons                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42200  Reconstruct cleft palate                          A  12.53  11.72NA  12.28NA  11.72    12.28     1.60  25.85  26.41  25.85  26.41  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42205  Reconstruct cleft palate                          A  13.66  12.89NA  14.46NA  12.89    14.46     1.77  28.32  29.89  28.32  29.89  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
4221F  Diuretic thxpy for >= 6 mons                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42210  Reconstruct cleft palate                          A  15.03  13.35NA  13.77NA  13.35    13.77     2.96  31.34  31.76  31.34  31.76  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42215  Reconstruct cleft palate                          A   8.99  10.62NA  11.52NA  10.62    11.52     1.78  21.39  22.29  21.39  22.29  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42220  Reconstruct cleft palate                          A   7.16   7.97NA   8.37NA   7.97     8.37     0.50  15.63  16.03  15.63  16.03  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42225  Reconstruct cleft palate                          A   9.77  16.18NA  15.96NA  16.18    15.96     1.25  27.20  26.98  27.20  26.98  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42226  Lengthening of palate                             A  10.35  15.59NA  15.81NA  15.59    15.81     1.32  27.26  27.48  27.26  27.48  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42227  Lengthening of palate                             A   9.90  14.87NA  14.63NA  14.87    14.63     1.26  26.03  25.79  26.03  25.79  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42235  Repair palate                                     A   8.01  13.03NA  13.51NA  13.03    13.51     1.03  22.07  22.55  22.07  22.55  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42260  Repair nose to lip fistula                        A  10.22  12.77    13.50     8.38     9.01     1.30  24.29  25.02  19.90  20.53  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42280  Preparation palate mold                           A   1.59   2.88     3.09     1.36     1.58     0.34   4.81   5.02   3.29   3.51  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
42281  Insertion palate prosthesis                       A   1.98   3.81     4.03     2.30     2.44     0.26   6.05   6.27   4.54   4.68  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
42299  Palate/uvula surgery                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
4230F  Anticonv thxpy for >= 6 mons                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42300  Drainage of salivary gland                        A   1.98   3.94     4.14     2.32     2.47     0.27   6.19   6.39   4.57   4.72  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42305  Drainage of salivary gland                        A   6.31   5.71NA   6.10NA   5.71     6.10     0.86  12.88  13.27  12.88  13.27  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42310  Drainage of salivary gland                        A   1.61   2.98     3.14     1.91     2.04     0.22   4.81   4.97   3.74   3.87  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
42320  Drainage of salivary gland                        A   2.40   4.70     4.95     2.58     2.75     0.31   7.41   7.66   5.29   5.46  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
42330  Removal of salivary stone                         A   2.26   4.32     4.52     2.38     2.55     0.30   6.88   7.08   4.94   5.11  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42335  Removal of salivary stone                         A   3.41   7.19     7.55     3.89     4.13     0.42  11.02  11.38   7.72   7.96  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
42340  Removal of salivary stone                         A   4.72   8.40     8.81     4.78     5.08     0.61  13.73  14.14  10.11  10.41  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
4240F  Instr xrcz 4bk pn >12 weeks                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42400  Biopsy of salivary gland                          A   0.78   2.32     2.33     0.82     0.82     0.08   3.18   3.19   1.68   1.68  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
42405  Biopsy of salivary gland                          A   3.34   5.10     5.27     2.99     3.18     0.42   8.86   9.03   6.75   6.94  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42408  Excision of salivary cyst                         A   4.66   8.21     8.68     4.57     4.94     0.60  13.47  13.94   9.83  10.20  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42409  Drainage of salivary cyst                         A   2.91   6.57     6.91     3.41     3.61     0.37   9.85  10.19   6.69   6.89  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42410  Excise parotid gland/lesion                       A   9.57   7.62NA   8.21NA   7.62     8.21     1.44  18.63  19.22  18.63  19.22  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42415  Excise parotid gland/lesion                       A  18.12  12.79NA  13.86NA  12.79    13.86     2.42  33.33  34.40  33.33  34.40  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4242F  Sprvsd xrcz bk pn >12 weeks                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42420  Excise parotid gland/lesion                       A  21.00  14.35NA  15.59NA  14.35    15.59     2.82  38.17  39.41  38.17  39.41  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42425  Excise parotid gland/lesion                       A  13.42   9.93NA  10.67NA   9.93    10.67     1.83  25.18  25.92  25.18  25.92  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42426  Excise parotid gland/lesion                       A  22.66  14.96NA  16.19NA  14.96    16.19     3.11  40.73  41.96  40.73  41.96  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42440  Excise submaxillary gland                         A   7.13   5.91NA   6.37NA   5.91     6.37     0.95  13.99  14.45  13.99  14.45  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4245F  Pt instr nrml lifest                              M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42450  Excise sublingual gland                           A   4.74   8.05     8.44     5.38     5.71     0.64  13.43  13.82  10.76  11.09  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
4248F  Pt instr no bd rest>= 4 days                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4250F  Wrmng 4 surg normothermia                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42500  Repair salivary duct                              A   4.42   7.81     8.19     5.23     5.54     0.60  12.83  13.21  10.25  10.56  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42505  Repair salivary duct                              A   6.32   9.36     9.85     6.47     6.88     0.80  16.48  16.97  13.59  14.00  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
42507  Parotid duct diversion                            A   6.25   8.37NA   8.79NA   8.37     8.79     0.80  15.42  15.84  15.42  15.84  0090.09.81.1022200             25.5217 090 99      0.00   0.00   0.00
42508  Parotid duct diversion                            A   9.33  10.60NA  10.74NA  10.60    10.74     1.20  21.13  21.27  21.13  21.27  0090.09.81.1022200             25.5217 090 99      0.00   0.00   0.00
42509  Parotid duct diversion                            A  11.76  10.49NA  10.17NA  10.49    10.17     2.30  24.55  24.23  24.55  24.23  0090.09.81.1022000             25.5217 090 99      0.00   0.00   0.00
42510  Parotid duct diversion                            A   8.35   9.47NA  10.03NA   9.47    10.03     1.07  18.89  19.45  18.89  19.45  0090.09.81.1022210             25.5217 090 99      0.00   0.00   0.00
4255F  Anesth 60+ min as docd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42550  Injection for salivary x-ray                      A   1.25   2.76     2.43     0.53     0.47     0.11   4.12   3.79   1.89   1.83  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
4256F  Anesthe <60 min as docd                           M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4260F  Wound srfc culturetech used                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42600  Closure of salivary fistula                       A   4.94   8.76     9.13     4.97     5.24     0.64  14.34  14.71  10.55  10.82  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
4261F  Tech other than surfc cultr                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4265F  Wet-dry dressings rx recmd                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42650  Dilation of salivary duct                         A   0.77   1.60     1.68     0.89     0.94     0.10   2.47   2.55   1.76   1.81  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
4266F  No wet-dry drssings rx recmd                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42660  Dilation of salivary duct                         A   1.13   1.87     1.97     1.06     1.13     0.14   3.14   3.24   2.33   2.40  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
42665  Ligation of salivary duct                         A   2.63   6.30     6.62     3.25     3.44     0.34   9.27   9.59   6.22   6.41  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
4267F  Comprssion thxpy prescribed                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4268F  Pt ed re comp thxpy rcvd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4269F  Appropos mthd offloading Rxd                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42699  Salivary surgery procedure                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
4270F  Pt rcvng anti r-viral thxpy                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42700  Drainage of tonsil abscess                        A   1.67   3.70     3.86     2.18     2.28     0.23   5.60   5.76   4.08   4.18  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
4271F  Pt rcvng anti r-viral thxpy                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42720  Drainage of throat abscess                        A   6.31   6.43     6.88     4.67     5.07     0.83  13.57  14.02  11.81  12.21  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
42725  Drainage of throat abscess                        A  12.41  10.30NA  11.14NA  10.30    11.14     1.59  24.30  25.14  24.30  25.14  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4274F  Flu immuno admind rcvd                            M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4275F  Hep b vac inj admin/rcvd                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4276F  Potent antivir thxpy Rxd                          M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4279F  PCP prophylaxis Rxd                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4280F  PCP prophylax Rxd 3mon low %                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42800  Biopsy of throat                                  A   1.44   3.07     3.22     1.74     1.84     0.20   4.71   4.86   3.38   3.48  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42802  Biopsy of throat                                  A   1.59   5.23     5.22     2.25     2.31     0.22   7.04   7.03   4.06   4.12  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42804  Biopsy of upper nose/throat                       A   1.29   4.48     4.53     1.99     2.05     0.16   5.93   5.98   3.44   3.50  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42806  Biopsy of upper nose/throat                       A   1.63   4.82     4.87     2.17     2.24     0.22   6.67   6.72   4.02   4.09  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42808  Excise pharynx lesion                             A   2.35   4.12     4.31     2.25     2.39     0.30   6.77   6.96   4.90   5.04  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42809  Remove pharynx foreign body                       A   1.86   2.92     3.06     1.78     1.91     0.27   5.05   5.19   3.91   4.04  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
42810  Excision of neck cyst                             A   3.38   7.73     8.06     4.82     5.13     0.42  11.53  11.86   8.62   8.93  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42815  Excision of neck cyst                             A   7.31   8.35NA   8.87NA   8.35     8.87     1.00  16.66  17.18  16.66  17.18  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42820  Remove tonsils and adenoids                       A   4.22   3.98NA   4.25NA   3.98     4.25     0.53   8.73   9.00   8.73   9.00  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42821  Remove tonsils and adenoids                       A   4.36   4.17NA   4.44NA   4.17     4.44     0.56   9.09   9.36   9.09   9.36  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42825  Removal of tonsils                                A   3.51   3.93NA   4.16NA   3.93     4.16     0.43   7.87   8.10   7.87   8.10  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42826  Removal of tonsils                                A   3.45   3.68NA   3.90NA   3.68     3.90     0.43   7.56   7.78   7.56   7.78  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
42830  Removal of adenoids                               A   2.65   3.24NA   3.42NA   3.24     3.42     0.34   6.23   6.41   6.23   6.41  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42831  Removal of adenoids                               A   2.81   3.55NA   3.74NA   3.55     3.74     0.35   6.71   6.90   6.71   6.90  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42835  Removal of adenoids                               A   2.38   2.67NA   2.59NA   2.67     2.59     0.30   5.35   5.27   5.35   5.27  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42836  Removal of adenoids                               A   3.26   3.59NA   3.78NA   3.59     3.78     0.41   7.26   7.45   7.26   7.45  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42842  Extensive surgery of throat                       A  12.23  15.73NA  16.84NA  15.73    16.84     1.58  29.54  30.65  29.54  30.65  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42844  Extensive surgery of throat                       A  17.78  20.83NA  22.09NA  20.83    22.09     2.27  40.88  42.14  40.88  42.14  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42845  Extensive surgery of throat                       A  32.56  29.68NA  31.94NA  29.68    31.94     4.17  66.41  68.67  66.41  68.67  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42860  Excision of tonsil tags                           A   2.30   3.06NA   3.22NA   3.06     3.22     0.30   5.66   5.82   5.66   5.82  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42870  Excision of lingual tonsil                        A   5.52  11.07NA  11.47NA  11.07    11.47     0.71  17.30  17.70  17.30  17.70  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
42890  Partial removal of pharynx                        A  19.13  20.34NA  21.96NA  20.34    21.96     2.51  41.98  43.60  41.98  43.60  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42892  Revision of pharyngeal walls                      A  26.03  25.95NA  28.45NA  25.95    28.45     3.41  55.39  57.89  55.39  57.89  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42894  Revision of pharyngeal walls                      A  33.92  31.90NA  34.69NA  31.90    34.69     4.41  70.23  73.02  70.23  73.02  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4290F  Pt scrned for inj drug use                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42900  Repair throat wound                               A   5.29   4.26NA   4.58NA   4.26     4.58     0.68  10.23  10.55  10.23  10.55  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
4293F  Pt scrnd hgh-risk sex behav                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
42950  Reconstruction of throat                          A   8.27  14.34NA  14.81NA  14.34    14.81     1.14  23.75  24.22  23.75  24.22  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
42953  Repair throat esophagus                           A   9.45  18.11NA  18.27NA  18.11    18.27     1.30  28.86  29.02  28.86  29.02  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42955  Surgical opening of throat                        A   8.01  13.36NA  14.03NA  13.36    14.03     1.03  22.40  23.07  22.40  23.07  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42960  Control throat bleeding                           A   2.38   2.39NA   2.54NA   2.39     2.54     0.31   5.08   5.23   5.08   5.23  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
42961  Control throat bleeding                           A   5.77   6.13NA   6.52NA   6.13     6.52     0.73  12.63  13.02  12.63  13.02  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42962  Control throat bleeding                           A   7.40   7.22NA   7.69NA   7.22     7.69     0.95  15.57  16.04  15.57  16.04  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
42970  Control nose/throat bleeding                      A   5.82   5.15NA   5.58NA   5.15     5.58     0.84  11.81  12.24  11.81  12.24  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
42971  Control nose/throat bleeding                      A   6.60   6.30NA   6.76NA   6.30     6.76     0.84  13.74  14.20  13.74  14.20  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42972  Control nose/throat bleeding                      A   7.59   6.82NA   7.34NA   6.82     7.34     0.98  15.39  15.91  15.39  15.91  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
42999  Throat surgery procedure                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
4300F  Pt rcvng warf thxpy                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4301F  Pt not rcvng warf thxpy                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43020  Incision of esophagus                             A   8.23   6.64NA   7.49NA   6.64     7.49     1.06  15.93  16.78  15.93  16.78  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43030  Throat muscle surgery                             A   7.99   6.47NA   6.90NA   6.47     6.90     1.17  15.63  16.06  15.63  16.06  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43045  Incision of esophagus                             A  21.88  12.41NA  12.24NA  12.41    12.24     5.11  39.40  39.23  39.40  39.23  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4305F  Pt ed re ft care inspct rcvd                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
4306F  Pt tlk psych & Rx opd addic                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43100  Excision of esophagus lesion                      A   9.66   7.82NA   8.60NA   7.82     8.60     1.24  18.72  19.50  18.72  19.50  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43101  Excision of esophagus lesion                      A  17.07   9.41NA   9.29NA   9.41     9.29     3.99  30.47  30.35  30.47  30.35  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43107  Removal of esophagus                              A  44.18  22.18NA  22.77NA  22.18    22.77     9.85  76.21  76.80  76.21  76.80  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43108  Removal of esophagus                              A  82.87  34.99NA  40.35NA  34.99    40.35    17.63 135.49 140.85 135.49 140.85  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43112  Removal of esophagus                              A  47.48  22.61NA  22.69NA  22.61    22.69    10.74  80.83  80.91  80.83  80.91  0090.09.81.1020220             25.5217 090 99      0.00   0.00   0.00
43113  Removal of esophagus                              A  80.06  36.60NA  40.50NA  36.60    40.50    17.04 133.70 137.60 133.70 137.60  0090.09.81.1020220             25.5217 090 99      0.00   0.00   0.00
43116  Partial removal of esophagus                      A  92.99  47.62NA  58.63NA  47.62    58.63    11.91 152.52 163.53 152.52 163.53  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43117  Partial removal of esophagus                      A  43.65  20.64NA  20.91NA  20.64    20.91     9.85  74.14  74.41  74.14  74.41  0090.09.81.1020220             25.5217 090 99      0.00   0.00   0.00
43118  Partial removal of esophagus                      A  67.07  29.34NA  33.45NA  29.34    33.45    14.27 110.68 114.79 110.68 114.79  0090.09.81.1020220             25.5217 090 99      0.00   0.00   0.00
43121  Partial removal of esophagus                      A  51.43  22.50NA  23.19NA  22.50    23.19    12.00  85.93  86.62  85.93  86.62  0090.09.81.1020220             25.5217 090 99      0.00   0.00   0.00
43122  Partial removal of esophagus                      A  44.18  21.64NA  22.75NA  21.64    22.75     9.61  75.43  76.54  75.43  76.54  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43123  Partial removal of esophagus                      A  83.12  35.91NA  41.83NA  35.91    41.83    17.67 136.70 142.62 136.70 142.62  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43124  Removal of esophagus                              A  69.09  32.29NA  36.58NA  32.29    36.58    16.15 117.53 121.82 117.53 121.82  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43130  Removal of esophagus pouch                        A  12.53   9.09NA   9.67NA   9.09     9.67     1.98  23.60  24.18  23.60  24.18  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43135  Removal of esophagus pouch                        A  26.17  12.68NA  13.21NA  12.68    13.21     5.96  44.81  45.34  44.81  45.34  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4320F  Pt talk psychsoc&rx oh dpnd                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43200  Esophagus endoscopy                               A   1.59   4.59     4.55     1.32     1.39     0.23   6.41   6.37   3.14   3.21  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43201  Esoph scope w/submucous inj                       A   2.09   6.37     6.22     1.49     1.50     0.30   8.76   8.61   3.88   3.89  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43202  Esophagus endoscopy biopsy                        A   1.89   6.21     6.07     1.28     1.33     0.29   8.39   8.25   3.46   3.51  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43204  Esoph scope w/sclerosis inj                       A   3.76   2.33NA   2.29NA   2.33     2.29     0.58   6.67   6.63   6.67   6.63  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43205  Esophagus endoscopy/ligation                      A   3.78   2.40NA   2.41NA   2.40     2.41     0.56   6.74   6.75   6.74   6.75  0000.00.00.0030000       43200 25.5217 090 99      0.00   0.00   0.00
43215  Esophagus endoscopy                               A   2.60   1.63NA   1.68NA   1.63     1.68     0.41   4.64   4.69   4.64   4.69  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43216  Esophagus endoscopy/lesion                        A   2.40   3.39     3.66     1.55     1.59     0.35   6.14   6.41   4.30   4.34  0000.00.00.0030000       43200 25.5217 090 99      0.00   0.00   0.00
43217  Esophagus endoscopy                               A   2.90   7.83     7.67     1.74     1.81     0.49  11.22  11.06   5.13   5.20  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43219  Esophagus endoscopy                               A   2.80   1.88NA   1.87NA   1.88     1.87     0.48   5.16   5.15   5.16   5.15  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43220  Esoph endoscopy dilation                          A   2.10   1.41NA   1.45NA   1.41     1.45     0.31   3.82   3.86   3.82   3.86  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43226  Esoph endoscopy dilation                          A   2.34   1.54NA   1.56NA   1.54     1.56     0.37   4.25   4.27   4.25   4.27  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43227  Esoph endoscopy repair                            A   3.59   2.19NA   2.23NA   2.19     2.23     0.54   6.32   6.36   6.32   6.36  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43228  Esoph endoscopy ablation                          A   3.76   2.36NA   2.39NA   2.36     2.39     0.58   6.70   6.73   6.70   6.73  0000.00.00.0030100       43200 25.5217 090 99      0.00   0.00   0.00
43231  Esoph endoscopy w/us exam                         A   3.19   2.06NA   2.07NA   2.06     2.07     0.48   5.73   5.74   5.73   5.74  0000.00.00.0030020       43235 25.5217 090 99      0.00   0.00   0.00
43232  Esoph endoscopy w/us fn bx                        A   4.47   2.73NA   2.74NA   2.73     2.74     0.69   7.89   7.90   7.89   7.90  0000.00.00.0030020       43235 25.5217 090 99      0.00   0.00   0.00
43234  Upper gi endoscopy exam                           A   2.01   5.96     5.79     1.28     1.33     0.34   8.31   8.14   3.63   3.68  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43235  Uppr gi endoscopy diagnosis                       A   2.39   6.03     5.74     1.61     1.62     0.37   8.79   8.50   4.37   4.38  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43236  Uppr gi scope w/submuc inj                        A   2.92   7.56     7.14     1.93     1.93     0.42  10.90  10.48   5.27   5.27  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43237  Endoscopic us exam esoph                          A   3.98   2.51NA   2.50NA   2.51     2.50     0.60   7.09   7.08   7.09   7.08  0000.00.00.0030000       43235 25.5217 090 99      0.00   0.00   0.00
43238  Uppr gi endoscopy w/us fn bx                      A   5.02   3.07NA   3.04NA   3.07     3.04     0.75   8.84   8.81   8.84   8.81  0000.00.00.0030000       43235 25.5217 090 99      0.00   0.00   0.00
43239  Upper gi endoscopy biopsy                         A   2.87   6.90     6.60     1.86     1.88     0.42  10.19   9.89   5.15   5.17  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
4324F  Pt queried prkns complic                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43240  Esoph endoscope w/drain cyst                      A   6.85   4.06NA   4.08NA   4.06     4.08     1.03  11.94  11.96  11.94  11.96  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43241  Upper GI endoscopy with tube                      A   2.59   1.70NA   1.72NA   1.70     1.72     0.39   4.68   4.70   4.68   4.70  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43242  Uppr gi endoscopy w/us fn bx                      A   7.30   4.37NA   4.38NA   4.37     4.38     1.07  12.74  12.75  12.74  12.75  0000.00.00.0030000       43235 25.5217 090 99      0.00   0.00   0.00
43243  Upper gi endoscopy & inject                       A   4.56   2.81NA   2.81NA   2.81     2.81     0.68   8.05   8.05   8.05   8.05  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43244  Upper GI endoscopy/ligation                       A   5.04   3.12NA   3.12NA   3.12     3.12     0.73   8.89   8.89   8.89   8.89  0000.00.00.0030000       43235 25.5217 090 99      0.00   0.00   0.00
43245  Uppr gi scope dilate strictr                      A   3.18   1.97NA   2.01NA   1.97     2.01     0.50   5.65   5.69   5.65   5.69  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43246  Place gastrostomy tube                            A   4.32   2.56NA   2.59NA   2.56     2.59     0.69   7.57   7.60   7.57   7.60  0000.00.00.0030020       43235 25.5217 090 99      0.00   0.00   0.00
43247  Operative upper GI endoscopy                      A   3.38   2.13NA   2.15NA   2.13     2.15     0.52   6.03   6.05   6.03   6.05  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43248  Uppr gi endoscopy/guide wire                      A   3.15   2.07NA   2.06NA   2.07     2.06     0.45   5.67   5.66   5.67   5.66  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43249  Esoph endoscopy dilation                          A   2.90   1.91NA   1.91NA   1.91     1.91     0.42   5.23   5.23   5.23   5.23  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
4325F  Med txmnt options rvwd w/pt                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43250  Upper GI endoscopy/tumor                          A   3.20   1.96NA   2.00NA   1.96     2.00     0.52   5.68   5.72   5.68   5.72  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43251  Operative upper GI endoscopy                      A   3.69   2.31NA   2.33NA   2.31     2.33     0.56   6.56   6.58   6.56   6.58  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43255  Operative upper GI endoscopy                      A   4.81   2.99NA   2.99NA   2.99     2.99     0.71   8.51   8.51   8.51   8.51  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43256  Uppr gi endoscopy w/stent                         A   4.34   2.65NA   2.65NA   2.65     2.65     0.68   7.67   7.67   7.67   7.67  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43257  Uppr gi scope w/thrml txmnt                       A   5.50   3.27NA   3.47NA   3.27     3.47     0.80   9.57   9.77   9.57   9.77  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43258  Operative upper GI endoscopy                      A   4.54   2.81NA   2.82NA   2.81     2.82     0.68   8.03   8.04   8.03   8.04  0000.00.00.0030100       43235 25.5217 090 99      0.00   0.00   0.00
43259  Endoscopic ultrasound exam                        A   5.19   3.20NA   3.20NA   3.20     3.20     0.75   9.14   9.14   9.14   9.14  0000.00.00.0030000       43235 25.5217 090 99      0.00   0.00   0.00
4326F  Pt asked re symp auto dysfxn                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43260  Endo cholangiopancreatograph                      A   5.95   3.62NA   3.61NA   3.62     3.61     0.87  10.44  10.43  10.44  10.43  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43261  Endo cholangiopancreatograph                      A   6.26   3.80NA   3.80NA   3.80     3.80     0.91  10.97  10.97  10.97  10.97  0000.00.00.0030100       43260 25.5217 090 99      0.00   0.00   0.00
43262  Endo cholangiopancreatograph                      A   7.38   4.42NA   4.42NA   4.42     4.42     1.09  12.89  12.89  12.89  12.89  0000.00.00.0030100       43260 25.5217 090 99      0.00   0.00   0.00
43263  Endo cholangiopancreatograph                      A   7.28   4.35NA   4.29NA   4.35     4.29     1.07  12.70  12.64  12.70  12.64  0000.00.00.0030100       43260 25.5217 090 99      0.00   0.00   0.00
43264  Endo cholangiopancreatograph                      A   8.89   5.27NA   5.26NA   5.27     5.26     1.30  15.46  15.45  15.46  15.45  0000.00.00.0030100       43260 25.5217 090 99      0.00   0.00   0.00
43265  Endo cholangiopancreatograph                      A  10.00   5.88NA   5.87NA   5.88     5.87     1.48  17.36  17.35  17.36  17.35  0000.00.00.0030100       43260 25.5217 090 99      0.00   0.00   0.00
43267  Endo cholangiopancreatograph                      A   7.38   4.37NA   4.37NA   4.37     4.37     1.09  12.84  12.84  12.84  12.84  0000.00.00.0030100       43260 25.5217 090 99      0.00   0.00   0.00
43268  Endo cholangiopancreatograph                      A   7.38   4.59NA   4.58NA   4.59     4.58     1.09  13.06  13.05  13.06  13.05  0000.00.00.0030100       43260 25.5217 090 99      0.00   0.00   0.00
43269  Endo cholangiopancreatograph                      A   8.20   4.87NA   4.87NA   4.87     4.87     1.21  14.28  14.28  14.28  14.28  0000.00.00.0030100       43260 25.5217 090 99      0.00   0.00   0.00
43271  Endo cholangiopancreatograph                      A   7.38   4.41NA   4.41NA   4.41     4.41     1.09  12.88  12.88  12.88  12.88  0000.00.00.0030100       43260 25.5217 090 99      0.00   0.00   0.00
43272  Endo cholangiopancreatograph                      A   7.38   4.42NA   4.45NA   4.42     4.45     1.09  12.89  12.92  12.89  12.92  0000.00.00.0030000       43260 25.5217 090 99      0.00   0.00   0.00
43273  Endoscopic pancreatoscopy                         A   2.24   1.29NA   1.25NA   1.29     1.25     0.33   3.86   3.82   3.86   3.82  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
43279  Lap myotomy heller                                A  22.10  11.01NA  12.06NA  11.01    12.06     4.70  37.81  38.86  37.81  38.86  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4328F  Pt asked re sleep disturb                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43280  Laparoscopy fundoplasty                           A  18.10   9.56NA  10.44NA   9.56    10.44     3.84  31.50  32.38  31.50  32.38  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43281  Lap paraesophag hern repair                       A  26.60  14.16NA  14.16NA  14.16    14.16     5.65  46.41  46.41  46.41  46.41  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43282  Lap paraesoph her rpr w/mesh                      A  30.10  15.67NA  15.67NA  15.67    15.67     6.37  52.14  52.14  52.14  52.14  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43283  Lap esoph lengthening                             A   2.95   1.29NA   1.29NA   1.29     1.29     0.60   4.84   4.84   4.84   4.84  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
43289  Laparoscope proc esoph                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
4330F  Cnslng epi spec sfty issues                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43300  Repair of esophagus                               A   9.33   7.88NA   8.60NA   7.88     8.60     1.20  18.41  19.13  18.41  19.13  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43305  Repair esophagus and fistula                      A  18.10  12.49NA  13.62NA  12.49    13.62     2.31  32.90  34.03  32.90  34.03  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43310  Repair of esophagus                               A  26.26  12.83NA  12.49NA  12.83    12.49     6.12  45.21  44.87  45.21  44.87  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43312  Repair esophagus and fistula                      A  29.25  13.23NA  12.35NA  13.23    12.35     6.84  49.32  48.44  49.32  48.44  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43313  Esophagoplasty congenital                         A  48.45  23.68NA  26.11NA  23.68    26.11    11.33  83.46  85.89  83.46  85.89  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43314  Tracheo-esophagoplasty cong                       A  53.43  24.88NA  23.24NA  24.88    23.24     6.86  85.17  83.53  85.17  83.53  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43320  Fuse esophagus & stomach                          A  23.31  12.58NA  13.41NA  12.58    13.41     4.97  40.86  41.69  40.86  41.69  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43325  Revise esophagus & stomach                        A  22.60  11.59NA  12.41NA  11.59    12.41     4.82  39.01  39.83  39.01  39.83  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43327  Esoph fundoplasty lap                             A  13.35   8.16NA   8.16NA   8.16     8.16     2.84  24.35  24.35  24.35  24.35  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43328  Esoph fundoplasty thor                            A  19.91  10.87NA  10.87NA  10.87    10.87     4.97  35.75  35.75  35.75  35.75  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43330  Esophagomyotomy abdominal                         A  22.19  11.48NA  12.46NA  11.48    12.46     4.77  38.44  39.42  38.44  39.42  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43331  Esophagomyotomy thoracic                          A  23.06  12.41NA  12.31NA  12.41    12.31     5.39  40.86  40.76  40.86  40.76  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43332  Transab esoph hiat hern rpr                       A  19.62  11.07NA  11.07NA  11.07    11.07     4.17  34.86  34.86  34.86  34.86  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43333  Transab esoph hiat hern rpr                       A  21.46  11.85NA  11.85NA  11.85    11.85     4.54  37.85  37.85  37.85  37.85  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43334  Transthor diaphrag hern rpr                       A  22.12  11.44NA  11.44NA  11.44    11.44     4.70  38.26  38.26  38.26  38.26  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43335  Transthor diaphrag hern rpr                       A  23.97  12.18NA  12.18NA  12.18    12.18     5.07  41.22  41.22  41.22  41.22  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43336  Thorabd diaphr hern repair                        A  25.81  13.52NA  13.52NA  13.52    13.52     5.84  45.17  45.17  45.17  45.17  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43337  Thorabd diaphr hern repair                        A  27.65  15.40NA  15.40NA  15.40    15.40     6.26  49.31  49.31  49.31  49.31  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43338  Esoph lengthening                                 A   2.21   1.30NA   1.30NA   1.30     1.30     0.50   4.01   4.01   4.01   4.01  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
43340  Fuse esophagus & intestine                        A  22.99  12.22NA  13.27NA  12.22    13.27     4.89  40.10  41.15  40.10  41.15  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43341  Fuse esophagus & intestine                        A  24.23  14.17NA  14.86NA  14.17    14.86     5.66  44.06  44.75  44.06  44.75  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43350  Surgical opening esophagus                        A  19.49  12.43NA  14.48NA  12.43    14.48     4.14  36.06  38.11  36.06  38.11  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43351  Surgical opening esophagus                        A  22.05  12.23NA  12.01NA  12.23    12.01     5.15  39.43  39.21  39.43  39.21  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43352  Surgical opening esophagus                        A  17.81  10.31NA  10.20NA  10.31    10.20     4.16  32.28  32.17  32.28  32.17  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43360  Gastrointestinal repair                           A  40.11  19.03NA  18.79NA  19.03    18.79     9.38  68.52  68.28  68.52  68.28  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43361  Gastrointestinal repair                           A  45.68  20.91NA  20.62NA  20.91    20.62     9.72  76.31  76.02  76.31  76.02  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
4340F  Cnslng chldbrng women epi                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43400  Ligate esophagus veins                            A  25.60  15.67NA  14.41NA  15.67    14.41     3.76  45.03  43.77  45.03  43.77  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43401  Esophagus surgery for veins                       A  26.49  12.38NA  12.55NA  12.38    12.55     5.64  44.51  44.68  44.51  44.68  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43405  Ligate/staple esophagus                           A  24.73  14.58NA  15.95NA  14.58    15.95     5.27  44.58  45.95  44.58  45.95  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43410  Repair esophagus wound                            A  16.41  10.66NA  11.43NA  10.66    11.43     3.83  30.90  31.67  30.90  31.67  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43415  Repair esophagus wound                            A  28.91  15.72NA  16.36NA  15.72    16.36     6.59  51.22  51.86  51.22  51.86  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43420  Repair esophagus opening                          A  16.78  11.26NA  12.81NA  11.26    12.81     2.15  30.19  31.74  30.19  31.74  0090.09.81.1020010             25.5217 090 99      0.00   0.00   0.00
43425  Repair esophagus opening                          A  25.04  14.46NA  15.22NA  14.46    15.22     5.34  44.84  45.60  44.84  45.60  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43450  Dilate esophagus                                  A   1.38   3.06     2.90     1.08     1.08     0.22   4.66   4.50   2.68   2.68  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43453  Dilate esophagus                                  A   1.51   7.02     6.58     1.16     1.15     0.23   8.76   8.32   2.90   2.89  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43456  Dilate esophagus                                  A   2.57  14.78    13.84     1.71     1.73     0.38  17.73  16.79   4.66   4.68  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43458  Dilate esophagus                                  A   3.06   7.97     7.68     1.94     1.98     0.45  11.48  11.19   5.45   5.49  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43460  Pressure treatment esophagus                      A   3.79   2.32NA   2.44NA   2.32     2.44     0.54   6.65   6.77   6.65   6.77  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43496  Free jejunum flap microvasc                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43499  Esophagus surgery procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020111             25.5217 090 99      0.00   0.00   0.00
43500  Surgical opening of stomach                       A  12.79   7.25NA   7.94NA   7.25     7.94     2.70  22.74  23.43  22.74  23.43  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43501  Surgical repair of stomach                        A  22.60  11.60NA  12.81NA  11.60    12.81     4.77  38.97  40.18  38.97  40.18  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43502  Surgical repair of stomach                        A  25.69  12.97NA  14.40NA  12.97    14.40     5.46  44.12  45.55  44.12  45.55  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43510  Surgical opening of stomach                       A  15.14  10.33NA  11.40NA  10.33    11.40     2.21  27.68  28.75  27.68  28.75  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43520  Incision of pyloric muscle                        A  11.29   6.54NA   6.83NA   6.54     6.83     2.50  20.33  20.62  20.33  20.62  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43605  Biopsy of stomach                                 A  13.72   7.71NA   8.67NA   7.71     8.67     2.87  24.30  25.26  24.30  25.26  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43610  Excision of stomach lesion                        A  16.34   8.62NA   9.52NA   8.62     9.52     3.45  28.41  29.31  28.41  29.31  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43611  Excision of stomach lesion                        A  20.38  10.72NA  11.79NA  10.72    11.79     4.29  35.39  36.46  35.39  36.46  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43620  Removal of stomach                                A  34.04  16.04NA  17.62NA  16.04    17.62     7.24  57.32  58.90  57.32  58.90  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43621  Removal of stomach                                A  39.53  17.90NA  19.95NA  17.90    19.95     8.39  65.82  67.87  65.82  67.87  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43622  Removal of stomach                                A  40.03  18.20NA  20.37NA  18.20    20.37     8.53  66.76  68.93  66.76  68.93  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43631  Removal of stomach partial                        A  24.51  12.41NA  13.66NA  12.41    13.66     5.19  42.11  43.36  42.11  43.36  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43632  Removal of stomach partial                        A  35.14  16.03NA  18.22NA  16.03    18.22     7.40  58.57  60.76  58.57  60.76  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43633  Removal of stomach partial                        A  33.14  15.38NA  17.38NA  15.38    17.38     6.98  55.50  57.50  55.50  57.50  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43634  Removal of stomach partial                        A  36.64  16.96NA  19.18NA  16.96    19.18     7.79  61.39  63.61  61.39  63.61  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43635  Removal of stomach partial                        A   2.06   0.81NA   0.89NA   0.81     0.89     0.42   3.29   3.37   3.29   3.37  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
43640  Vagotomy & pylorus repair                         A  19.56  10.44NA  11.57NA  10.44    11.57     4.11  34.11  35.24  34.11  35.24  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43641  Vagotomy & pylorus repair                         A  19.81  10.57NA  11.83NA  10.57    11.83     4.21  34.59  35.85  34.59  35.85  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43644  Lap gastric bypass/roux-en-y                      A  29.40  14.75NA  16.19NA  14.75    16.19     6.21  50.36  51.80  50.36  51.80  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43645  Lap gastr bypass incl smll i                      A  31.53  15.57NA  17.14NA  15.57    17.14     6.72  53.82  55.39  53.82  55.39  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43647  Lap impl electrode antrum                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
43648  Lap revise/remv eltrd antrum                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
43651  Laparoscopy vagus nerve                           A  10.13   6.56NA   7.17NA   6.56     7.17     2.16  18.85  19.46  18.85  19.46  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
43652  Laparoscopy vagus nerve                           A  12.13   7.33NA   8.04NA   7.33     8.04     2.58  22.04  22.75  22.04  22.75  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
43653  Laparoscopy gastrostomy                           A   8.48   6.09NA   6.66NA   6.09     6.66     1.81  16.38  16.95  16.38  16.95  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43659  Laparoscope proc stom                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
43752  Nasal/orogastric w/stent                          A   0.81   0.33NA   0.32NA   0.33     0.32     0.08   1.22   1.21   1.22   1.21  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
43753  Tx gastro intub w/asp                             A   0.45   0.13NA   0.13NA   0.13     0.13     0.03   0.61   0.61   0.61   0.61  0000.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
43754  Dx gastr intub w/asp spec                         A   0.45   1.84     1.84     0.44     0.44     0.04   2.33   2.33   0.93   0.93  0000.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
43755  Dx gastr intub w/asp specs                        A   0.94   2.53     2.53     0.68     0.68     0.08   3.55   3.55   1.70   1.70  0000.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
43756  Dx duod intub w/asp spec                          A   0.77   5.62     5.62     0.71     0.71     0.05   6.44   6.44   1.53   1.53  0000.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
43757  Dx duod intub w/asp specs                         A   1.26   6.95     6.95     0.87     0.87     0.08   8.29   8.29   2.21   2.21  0000.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
43760  Change gastrostomy tube                           A   0.90  10.90    12.32     0.43     0.42     0.14  11.94  13.36   1.47   1.46  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43761  Reposition gastrostomy tube                       A   2.01   1.30     1.22     0.88     0.83     0.24   3.55   3.47   3.13   3.08  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
43770  Lap place gastr adj device                        A  18.00  10.54NA  11.55NA  10.54    11.55     3.80  32.34  33.35  32.34  33.35  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43771  Lap revise gastr adj device                       A  20.79  11.63NA  12.80NA  11.63    12.80     4.43  36.85  38.02  36.85  38.02  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
43772  Lap rmvl gastr adj device                         A  15.70   8.70NA   9.51NA   8.70     9.51     3.35  27.75  28.56  27.75  28.56  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43773  Lap replace gastr adj device                      A  20.79  11.63NA  12.77NA  11.63    12.77     4.43  36.85  37.99  36.85  37.99  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43774  Lap rmvl gastr adj all parts                      A  15.76   8.73NA   9.52NA   8.73     9.52     3.35  27.84  28.63  27.84  28.63  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
43775  Lap sleeve gastrectomy                            N+ 21.56  12.14NA  12.14NA  12.14    12.14     4.59  38.29  38.29  38.29  38.29  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
43800  Reconstruction of pylorus                         A  15.43   8.23NA   9.01NA   8.23     9.01     3.30  26.96  27.74  26.96  27.74  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43810  Fusion of stomach and bowel                       A  16.88   8.89NA   9.88NA   8.89     9.88     3.59  29.36  30.35  29.36  30.35  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43820  Fusion of stomach and bowel                       A  22.53  11.31NA  12.79NA  11.31    12.79     4.75  38.59  40.07  38.59  40.07  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43825  Fusion of stomach and bowel                       A  21.76  11.41NA  12.72NA  11.41    12.72     4.63  37.80  39.11  37.80  39.11  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43830  Place gastrostomy tube                            A  10.85   7.07NA   7.71NA   7.07     7.71     2.23  20.15  20.79  20.15  20.79  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43831  Place gastrostomy tube                            A   8.49   6.74NA   7.32NA   6.74     7.32     1.81  17.04  17.62  17.04  17.62  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43832  Place gastrostomy tube                            A  17.34   9.67NA  10.41NA   9.67    10.41     3.57  30.58  31.32  30.58  31.32  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43840  Repair of stomach lesion                          A  22.83  11.47NA  12.95NA  11.47    12.95     4.81  39.11  40.59  39.11  40.59  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43842  V-band gastroplasty                               N+ 21.03  11.26NA  11.67NA  11.26    11.67     1.49  33.78  34.19  33.78  34.19  9090.09.81.1099999             25.5217 090 99      0.00   0.00   0.00
43843  Gastroplasty w/o v-band                           A  21.21  11.18NA  12.49NA  11.18    12.49     4.51  36.90  38.21  36.90  38.21  0090.09.81.1020220             25.5217 090 99      0.00   0.00   0.00
43845  Gastroplasty duodenal switch                      A  33.30  16.42NA  18.37NA  16.42    18.37     7.05  56.77  58.72  56.77  58.72  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43846  Gastric bypass for obesity                        A  27.41  14.12NA  15.57NA  14.12    15.57     5.79  47.32  48.77  47.32  48.77  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43847  Gastric bypass incl small i                       A  30.28  15.23NA  17.12NA  15.23    17.12     6.44  51.95  53.84  51.95  53.84  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43848  Revision gastroplasty                             A  32.75  16.34NA  18.09NA  16.34    18.09     6.93  56.02  57.77  56.02  57.77  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43850  Revise stomach-bowel fusion                       A  27.58  13.59NA  15.22NA  13.59    15.22     5.87  47.04  48.67  47.04  48.67  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43855  Revise stomach-bowel fusion                       A  28.69  14.17NA  15.71NA  14.17    15.71     6.10  48.96  50.50  48.96  50.50  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43860  Revise stomach-bowel fusion                       A  27.89  13.69NA  15.08NA  13.69    15.08     5.87  47.45  48.84  47.45  48.84  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43865  Revise stomach-bowel fusion                       A  29.05  14.28NA  15.86NA  14.28    15.86     6.18  49.51  51.09  49.51  51.09  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43870  Repair stomach opening                            A  11.44   6.75NA   7.43NA   6.75     7.43     2.35  20.54  21.22  20.54  21.22  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43880  Repair stomach-bowel fistula                      A  27.18  13.46NA  14.84NA  13.46    14.84     5.69  46.33  47.71  46.33  47.71  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43881  Impl/redo electrd antrum                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
43882  Revise/remove electrd antrum                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
43886  Revise gastric port open                          A   4.64   4.63NA   5.06NA   4.63     5.06     0.99  10.26  10.69  10.26  10.69  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
43887  Remove gastric port open                          A   4.32   4.07NA   4.41NA   4.07     4.41     0.91   9.30   9.64   9.30   9.64  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
43888  Change gastric port open                          A   6.44   5.33NA   5.81NA   5.33     5.81     1.37  13.14  13.62  13.14  13.62  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
43999  Stomach surgery procedure                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
4400F  Rehab thxpy options w/pt                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
44005  Freeing of bowel adhesion                         A  18.46   9.43NA  10.40NA   9.43    10.40     3.83  31.72  32.69  31.72  32.69  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44010  Incision of small bowel                           A  14.26   7.82NA   8.62NA   7.82     8.62     3.00  25.08  25.88  25.08  25.88  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44015  Insert needle cath bowel                          A   2.62   1.03NA   1.10NA   1.03     1.10     0.56   4.21   4.28   4.21   4.28  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
44020  Explore small intestine                           A  16.22   8.56NA   9.47NA   8.56     9.47     3.40  28.18  29.09  28.18  29.09  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44021  Decompress small bowel                            A  16.31   8.72NA   9.59NA   8.72     9.59     3.44  28.47  29.34  28.47  29.34  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44025  Incision of large bowel                           A  16.51   8.69NA   9.60NA   8.69     9.60     3.42  28.62  29.53  28.62  29.53  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44050  Reduce bowel obstruction                          A  15.52   8.31NA   9.16NA   8.31     9.16     3.23  27.06  27.91  27.06  27.91  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44055  Correct malrotation of bowel                      A  25.63  12.34NA  13.69NA  12.34    13.69     5.40  43.37  44.72  43.37  44.72  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44100  Biopsy of bowel                                   A   2.01   1.10NA   1.09NA   1.10     1.09     0.31   3.42   3.41   3.42   3.41  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
44110  Excise intestine lesion(s)                        A  14.04   7.65NA   8.42NA   7.65     8.42     2.89  24.58  25.35  24.58  25.35  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44111  Excision of bowel lesion(s)                       A  16.52   8.60NA   9.49NA   8.60     9.49     3.44  28.56  29.45  28.56  29.45  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44120  Removal of small intestine                        A  20.82  10.29NA  11.44NA  10.29    11.44     4.32  35.43  36.58  35.43  36.58  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44121  Removal of small intestine                        A   4.44   1.76NA   1.93NA   1.76     1.93     0.90   7.10   7.27   7.10   7.27  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
44125  Removal of small intestine                        A  20.03  10.16NA  11.25NA  10.16    11.25     4.06  34.25  35.34  34.25  35.34  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44126  Enterectomy w/o taper cong                        A  42.23  20.09NA  22.56NA  20.09    22.56     8.98  71.30  73.77  71.30  73.77  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44127  Enterectomy w/taper cong                          A  49.30  22.80NA  25.55NA  22.80    25.55    10.48  82.58  85.33  82.58  85.33  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44128  Enterectomy cong add-on                           A   4.44   1.77NA   1.94NA   1.77     1.94     0.92   7.13   7.30   7.13   7.30  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
44130  Bowel to bowel fusion                             A  22.11  11.13NA  12.62NA  11.13    12.62     4.55  37.79  39.28  37.79  39.28  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44132  Enterectomy cadaver donor                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
44133  Enterectomy live donor                            R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
44135  Intestine transplnt cadaver                       R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
44136  Intestine transplant live                         R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
44137  Remove intestinal allograft                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
44139  Mobilization of colon                             A   2.23   0.88NA   0.97NA   0.88     0.97     0.43   3.54   3.63   3.54   3.63  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
44140  Partial removal of colon                          A  22.59  11.69NA  12.89NA  11.69    12.89     4.63  38.91  40.11  38.91  40.11  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44141  Partial removal of colon                          A  29.91  16.48NA  18.48NA  16.48    18.48     6.17  52.56  54.56  52.56  54.56  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44143  Partial removal of colon                          A  27.79  14.76NA  16.30NA  14.76    16.30     5.73  48.28  49.82  48.28  49.82  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44144  Partial removal of colon                          A  29.91  15.10NA  16.93NA  15.10    16.93     6.17  51.18  53.01  51.18  53.01  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44145  Partial removal of colon                          A  28.58  14.03NA  15.51NA  14.03    15.51     5.65  48.26  49.74  48.26  49.74  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44146  Partial removal of colon                          A  35.30  19.04NA  21.23NA  19.04    21.23     6.86  61.20  63.39  61.20  63.39  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44147  Partial removal of colon                          A  33.69  15.51NA  17.78NA  15.51    17.78     6.76  55.96  58.23  55.96  58.23  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44150  Removal of colon                                  A  30.18  17.71NA  19.64NA  17.71    19.64     6.11  54.00  55.93  54.00  55.93  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44151  Removal of colon/ileostomy                        A  34.92  19.58NA  21.70NA  19.58    21.70     7.43  61.93  64.05  61.93  64.05  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44155  Removal of colon/ileostomy                        A  34.42  19.21NA  21.44NA  19.21    21.44     6.45  60.08  62.31  60.08  62.31  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44156  Removal of colon/ileostomy                        A  37.42  21.25NA  23.63NA  21.25    23.63     7.97  66.64  69.02  66.64  69.02  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44157  Colectomy w/ileoanal anast                        A  35.70  19.70NA  21.80NA  19.70    21.80     7.60  63.00  65.10  63.00  65.10  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44158  Colectomy w/neo-rectum pouch                      A  36.70  19.98NA  22.08NA  19.98    22.08     7.81  64.49  66.59  64.49  66.59  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44160  Removal of colon                                  A  20.89  10.85NA  12.03NA  10.85    12.03     4.25  35.99  37.17  35.99  37.17  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44180  Lap enterolysis                                   A  15.27   8.28NA   9.05NA   8.28     9.05     3.16  26.71  27.48  26.71  27.48  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44186  Lap jejunostomy                                   A  10.38   6.35NA   6.85NA   6.35     6.85     2.21  18.94  19.44  18.94  19.44  0090.09.84.0720210             25.5217 090 99      0.00   0.00   0.00
44187  Lap ileo/jejuno-stomy                             A  17.40  11.21NA  12.29NA  11.21    12.29     3.30  31.91  32.99  31.91  32.99  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44188  Lap colostomy                                     A  19.35  12.23NA  13.42NA  12.23    13.42     3.83  35.41  36.60  35.41  36.60  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44202  Lap enterectomy                                   A  23.39  12.04NA  13.28NA  12.04    13.28     4.83  40.26  41.50  40.26  41.50  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44203  Lap resect s/intestine addl                       A   4.44   1.74NA   1.92NA   1.74     1.92     0.92   7.10   7.28   7.10   7.28  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
44204  Laparo partial colectomy                          A  26.42  13.13NA  14.55NA  13.13    14.55     5.21  44.76  46.18  44.76  46.18  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44205  Lap colectomy part w/ileum                        A  22.95  11.54NA  12.77NA  11.54    12.77     4.49  38.98  40.21  38.98  40.21  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44206  Lap part colectomy w/stoma                        A  29.79  15.23NA  16.86NA  15.23    16.86     6.04  51.06  52.69  51.06  52.69  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44207  L colectomy/coloproctostomy                       A  31.92  15.14NA  16.86NA  15.14    16.86     6.17  53.23  54.95  53.23  54.95  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44208  L colectomy/coloproctostomy                       A  33.99  17.46NA  19.35NA  17.46    19.35     6.38  57.83  59.72  57.83  59.72  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44210  Laparo total proctocolectomy                      A  30.09  16.20NA  17.95NA  16.20    17.95     5.80  52.09  53.84  52.09  53.84  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44211  Lap colectomy w/proctectomy                       A  37.08  20.00NA  22.46NA  20.00    22.46     7.90  64.98  67.44  64.98  67.44  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44212  Laparo total proctocolectomy                      A  34.58  18.80NA  20.78NA  18.80    20.78     6.36  59.74  61.72  59.74  61.72  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44213  Lap mobil splenic fl add-on                       A   3.50   1.38NA   1.52NA   1.38     1.52     0.67   5.55   5.69   5.55   5.69  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
44227  Lap close enterostomy                             A  28.62  14.14NA  15.65NA  14.14    15.65     5.83  48.59  50.10  48.59  50.10  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44238  Laparoscope proc intestine                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
44300  Open bowel to skin                                A  13.75   7.77NA   8.52NA   7.77     8.52     2.91  24.43  25.18  24.43  25.18  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44310  Ileostomy/jejunostomy                             A  17.59   9.24NA  10.20NA   9.24    10.20     3.45  30.28  31.24  30.28  31.24  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44312  Revision of ileostomy                             A   9.43   6.06NA   6.47NA   6.06     6.47     1.71  17.20  17.61  17.20  17.61  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
44314  Revision of ileostomy                             A  16.74   9.39NA  10.22NA   9.39    10.22     3.15  29.28  30.11  29.28  30.11  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44316  Devise bowel pouch                                A  23.59  12.22NA  13.61NA  12.22    13.61     5.02  40.83  42.22  40.83  42.22  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44320  Colostomy                                         A  19.91  10.82NA  11.96NA  10.82    11.96     4.06  34.79  35.93  34.79  35.93  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44322  Colostomy with biopsies                           A  13.32  12.28NA  13.43NA  12.28    13.43     2.84  28.44  29.59  28.44  29.59  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44340  Revision of colostomy                             A   9.28   6.68NA   7.38NA   6.68     7.38     1.87  17.83  18.53  17.83  18.53  0090.09.81.1020110             25.5217 090 99      0.00   0.00   0.00
44345  Revision of colostomy                             A  17.22   9.81NA  10.84NA   9.81    10.84     3.44  30.47  31.50  30.47  31.50  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44346  Revision of colostomy                             A  19.63  10.72NA  11.91NA  10.72    11.91     3.87  34.22  35.41  34.22  35.41  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44360  Small bowel endoscopy                             A   2.59   1.77NA   1.76NA   1.77     1.76     0.38   4.74   4.73   4.74   4.73  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
44361  Small bowel endoscopy/biopsy                      A   2.87   1.92NA   1.92NA   1.92     1.92     0.41   5.20   5.20   5.20   5.20  0000.00.00.0030100       44360 25.5217 090 99      0.00   0.00   0.00
44363  Small bowel endoscopy                             A   3.49   2.20NA   2.24NA   2.20     2.24     0.52   6.21   6.25   6.21   6.25  0000.00.00.0030000       44360 25.5217 090 99      0.00   0.00   0.00
44364  Small bowel endoscopy                             A   3.73   2.38NA   2.38NA   2.38     2.38     0.54   6.65   6.65   6.65   6.65  0000.00.00.0030000       44360 25.5217 090 99      0.00   0.00   0.00
44365  Small bowel endoscopy                             A   3.31   2.14NA   2.15NA   2.14     2.15     0.49   5.94   5.95   5.94   5.95  0000.00.00.0030000       44360 25.5217 090 99      0.00   0.00   0.00
44366  Small bowel endoscopy                             A   4.40   2.78NA   2.78NA   2.78     2.78     0.64   7.82   7.82   7.82   7.82  0000.00.00.0030100       44360 25.5217 090 99      0.00   0.00   0.00
44369  Small bowel endoscopy                             A   4.51   2.83NA   2.84NA   2.83     2.84     0.65   7.99   8.00   7.99   8.00  0000.00.00.0030000       44360 25.5217 090 99      0.00   0.00   0.00
44370  Small bowel endoscopy/stent                       A   4.79   3.15NA   3.18NA   3.15     3.18     0.69   8.63   8.66   8.63   8.66  0000.00.00.0030000       44360 25.5217 090 99      0.00   0.00   0.00
44372  Small bowel endoscopy                             A   4.40   2.59NA   2.64NA   2.59     2.64     0.69   7.68   7.73   7.68   7.73  0000.00.00.0030100       44360 25.5217 090 99      0.00   0.00   0.00
44373  Small bowel endoscopy                             A   3.49   2.16NA   2.16NA   2.16     2.16     0.53   6.18   6.18   6.18   6.18  0000.00.00.0030100       44360 25.5217 090 99      0.00   0.00   0.00
44376  Small bowel endoscopy                             A   5.25   3.08NA   3.10NA   3.08     3.10     0.81   9.14   9.16   9.14   9.16  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
44377  Small bowel endoscopy/biopsy                      A   5.52   3.33NA   3.33NA   3.33     3.33     0.81   9.66   9.66   9.66   9.66  0000.00.00.0030000       44376 25.5217 090 99      0.00   0.00   0.00
44378  Small bowel endoscopy                             A   7.12   4.25NA   4.27NA   4.25     4.27     1.05  12.42  12.44  12.42  12.44  0000.00.00.0030000       44376 25.5217 090 99      0.00   0.00   0.00
44379  S bowel endoscope w/stent                         A   7.46   4.61NA   4.69NA   4.61     4.69     1.09  13.16  13.24  13.16  13.24  0000.00.00.0030000       44376 25.5217 090 99      0.00   0.00   0.00
44380  Small bowel endoscopy                             A   1.05   0.86NA   0.84NA   0.86     0.84     0.14   2.05   2.03   2.05   2.03  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
44382  Small bowel endoscopy                             A   1.27   1.01NA   1.01NA   1.01     1.01     0.20   2.48   2.48   2.48   2.48  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
44383  Ileoscopy w/stent                                 A   2.94   1.79NA   1.62NA   1.79     1.62     0.33   5.06   4.89   5.06   4.89  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
44385  Endoscopy of bowel pouch                          A   1.82   5.39     5.37     1.08     1.11     0.26   7.47   7.45   3.16   3.19  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
44386  Endoscopy bowel pouch/biop                        A   2.12   7.85     7.66     1.31     1.38     0.33  10.30  10.11   3.76   3.83  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
44388  Colonoscopy                                       A   2.82   7.03     6.97     1.70     1.75     0.45  10.30  10.24   4.97   5.02  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
44389  Colonoscopy with biopsy                           A   3.13   8.17     7.93     1.93     1.97     0.49  11.79  11.55   5.55   5.59  0000.00.00.0030100       44388 25.5217 090 99      0.00   0.00   0.00
44390  Colonoscopy for foreign body                      A   3.82   9.33     9.19     2.32     2.45     0.56  13.71  13.57   6.70   6.83  0000.00.00.0030000       44388 25.5217 090 99      0.00   0.00   0.00
44391  Colonoscopy for bleeding                          A   4.31  10.06     9.55     2.59     2.62     0.65  15.02  14.51   7.55   7.58  0000.00.00.0030000       44388 25.5217 090 99      0.00   0.00   0.00
44392  Colonoscopy & polypectomy                         A   3.81   8.49     8.41     2.13     2.21     0.62  12.92  12.84   6.56   6.64  0000.00.00.0030100       44388 25.5217 090 99      0.00   0.00   0.00
44393  Colonoscopy lesion removal                        A   4.83   9.39     9.32     2.76     2.85     0.76  14.98  14.91   8.35   8.44  0000.00.00.0030100       44388 25.5217 090 99      0.00   0.00   0.00
44394  Colonoscopy w/snare                               A   4.42   9.81     9.53     2.58     2.63     0.69  14.92  14.64   7.69   7.74  0000.00.00.0030100       44388 25.5217 090 99      0.00   0.00   0.00
44397  Colonoscopy w/stent                               A   4.70   2.89NA   2.94NA   2.89     2.94     0.68   8.27   8.32   8.27   8.32  0000.00.00.0030100       44388 25.5217 090 99      0.00   0.00   0.00
44500  Intro gastrointestinal tube                       A   0.49   0.21NA   0.19NA   0.21     0.19     0.04   0.74   0.72   0.74   0.72  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
44602  Suture small intestine                            A  24.72  10.90NA  12.45NA  10.90    12.45     5.09  40.71  42.26  40.71  42.26  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44603  Suture small intestine                            A  28.16  12.79NA  14.59NA  12.79    14.59     5.74  46.69  48.49  46.69  48.49  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44604  Suture large intestine                            A  18.16   8.83NA   9.77NA   8.83     9.77     3.71  30.70  31.64  30.70  31.64  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44605  Repair of bowel lesion                            A  22.08  11.34NA  12.54NA  11.34    12.54     4.55  37.97  39.17  37.97  39.17  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44615  Intestinal stricturoplasty                        A  18.16   9.39NA  10.36NA   9.39    10.36     3.72  31.27  32.24  31.27  32.24  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44620  Repair bowel opening                              A  14.43   7.83NA   8.72NA   7.83     8.72     2.82  25.08  25.97  25.08  25.97  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44625  Repair bowel opening                              A  17.28   8.93NA   9.95NA   8.93     9.95     3.35  29.56  30.58  29.56  30.58  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44626  Repair bowel opening                              A  27.90  13.15NA  14.56NA  13.15    14.56     5.69  46.74  48.15  46.74  48.15  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44640  Repair bowel-skin fistula                         A  24.20  11.73NA  12.97NA  11.73    12.97     4.88  40.81  42.05  40.81  42.05  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44650  Repair bowel fistula                              A  25.12  12.08NA  13.23NA  12.08    13.23     5.05  42.25  43.40  42.25  43.40  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44660  Repair bowel-bladder fistula                      A  23.91  11.93NA  12.16NA  11.93    12.16     3.84  39.68  39.91  39.68  39.91  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44661  Repair bowel-bladder fistula                      A  27.35  13.04NA  13.99NA  13.04    13.99     5.09  45.48  46.43  45.48  46.43  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44680  Surgical revision intestine                       A  17.96   9.29NA  10.27NA   9.29    10.27     3.83  31.08  32.06  31.08  32.06  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44700  Suspend bowel w/prosthesis                        A  17.48   9.00NA   9.98NA   9.00     9.98     3.03  29.51  30.49  29.51  30.49  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44701  Intraop colon lavage add-on                       A   3.10   1.21NA   1.34NA   1.21     1.34     0.58   4.89   5.02   4.89   5.02  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
44715  Prepare donor intestine                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
44720  Prep donor intestine/venous                       A   5.00   2.13NA   2.18NA   2.13     2.18     0.35   7.48   7.53   7.48   7.53  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
44721  Prep donor intestine/artery                       A   7.00   2.82NA   3.08NA   2.82     3.08     1.49  11.31  11.57  11.31  11.57  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
44799  Unlisted procedure intestine                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020111             25.5217 090 99      0.00   0.00   0.00
44800  Excision of bowel pouch                           A  12.05   7.56NA   8.24NA   7.56     8.24     2.43  22.04  22.72  22.04  22.72  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44820  Excision of mesentery lesion                      A  13.73   7.78NA   8.49NA   7.78     8.49     2.82  24.33  25.04  24.33  25.04  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44850  Repair of mesentery                               A  12.11   7.00NA   7.76NA   7.00     7.76     2.51  21.62  22.38  21.62  22.38  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44899  Bowel surgery procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
44900  Drain app abscess open                            A  12.57   7.12NA   7.90NA   7.12     7.90     2.63  22.32  23.10  22.32  23.10  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44901  Drain app abscess percut                          A   3.37  24.14    21.51     1.39     1.26     0.35  27.86  25.23   5.11   4.98  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
44950  Appendectomy                                      A  10.60   5.79NA   6.34NA   5.79     6.34     2.23  18.62  19.17  18.62  19.17  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44955  Appendectomy add-on                               A   1.53   0.62NA   0.68NA   0.62     0.68     0.31   2.46   2.52   2.46   2.52  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
44960  Appendectomy                                      A  14.50   7.71NA   8.54NA   7.71     8.54     3.07  25.28  26.11  25.28  26.11  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
44970  Laparoscopy appendectomy                          A   9.45   5.86NA   6.44NA   5.86     6.44     1.97  17.28  17.86  17.28  17.86  0090.09.81.1020220             25.5217 090 99      0.00   0.00   0.00
44979  Laparoscope proc app                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
45000  Drainage of pelvic abscess                        A   6.30   4.74NA   5.15NA   4.74     5.15     1.09  12.13  12.54  12.13  12.54  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
45005  Drainage of rectal abscess                        A   2.02   5.08     5.31     2.10     2.25     0.38   7.48   7.71   4.50   4.65  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
45020  Drainage of rectal abscess                        A   8.56   6.02NA   6.70NA   6.02     6.70     1.62  16.20  16.88  16.20  16.88  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
45100  Biopsy of rectum                                  A   4.04   3.73NA   4.07NA   3.73     4.07     0.72   8.49   8.83   8.49   8.83  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
45108  Removal of anorectal lesion                       A   5.12   4.25NA   4.70NA   4.25     4.70     1.09  10.46  10.91  10.46  10.91  0090.09.81.1020110             25.5217 090 99      0.00   0.00   0.00
45110  Removal of rectum                                 A  30.76  17.06NA  18.89NA  17.06    18.89     5.81  53.63  55.46  53.63  55.46  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45111  Partial removal of rectum                         A  18.01  10.03NA  11.10NA  10.03    11.10     3.54  31.58  32.65  31.58  32.65  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45112  Removal of rectum                                 A  33.18  15.61NA  17.42NA  15.61    17.42     6.07  54.86  56.67  54.86  56.67  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45113  Partial proctectomy                               A  33.22  17.08NA  18.99NA  17.08    18.99     7.06  57.36  59.27  57.36  59.27  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45114  Partial removal of rectum                         A  30.79  15.09NA  16.98NA  15.09    16.98     6.56  52.44  54.33  52.44  54.33  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45116  Partial removal of rectum                         A  27.72  13.78NA  15.62NA  13.78    15.62     3.95  45.45  47.29  45.45  47.29  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45119  Remove rectum w/reservoir                         A  33.48  17.17NA  19.30NA  17.17    19.30     5.85  56.50  58.63  56.50  58.63  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45120  Removal of rectum                                 A  26.40  13.91NA  15.47NA  13.91    15.47     5.62  45.93  47.49  45.93  47.49  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45121  Removal of rectum and colon                       A  29.08  14.91NA  16.64NA  14.91    16.64     6.18  50.17  51.90  50.17  51.90  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45123  Partial proctectomy                               A  18.86  10.16NA  11.50NA  10.16    11.50     3.16  32.18  33.52  32.18  33.52  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45126  Pelvic exenteration                               A  49.10  24.96NA  26.72NA  24.96    26.72    10.44  84.50  86.26  84.50  86.26  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
45130  Excision of rectal prolapse                       A  18.50   9.81NA  11.07NA   9.81    11.07     3.12  31.43  32.69  31.43  32.69  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45135  Excision of rectal prolapse                       A  22.36  12.35NA  13.95NA  12.35    13.95     4.75  39.46  41.06  39.46  41.06  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45136  Excise ileoanal reservior                         A  30.82  17.17NA  19.04NA  17.17    19.04     4.40  52.39  54.26  52.39  54.26  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45150  Excision of rectal stricture                      A   5.85   4.74NA   5.16NA   4.74     5.16     0.83  11.42  11.84  11.42  11.84  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
45160  Excision of rectal lesion                         A  16.33   9.36NA  10.30NA   9.36    10.30     3.48  29.17  30.11  29.17  30.11  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45171  Exc rect tum transanal part                       A   8.13   8.06NA   8.06NA   8.06     8.06     1.51  17.70  17.70  17.70  17.70  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45172  Exc rect tum transanal full                       A  12.13   9.80NA   9.80NA   9.80     9.80     2.23  24.16  24.16  24.16  24.16  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45190  Destruction rectal tumor                          A  10.42   7.45NA   8.26NA   7.45     8.26     1.86  19.73  20.54  19.73  20.54  0090.09.81.1020110             25.5217 090 99      0.00   0.00   0.00
45300  Proctosigmoidoscopy dx                            A   0.80   2.43     2.59     0.60     0.68     0.12   3.35   3.51   1.52   1.60  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
45303  Proctosigmoidoscopy dilate                        A   1.50  24.19    24.73     0.86     1.00     0.26  25.95  26.49   2.62   2.76  0000.00.00.0030100       45300 25.5217 090 99      0.00   0.00   0.00
45305  Proctosigmoidoscopy w/bx                          A   1.25   3.90     4.08     0.81     0.90     0.23   5.38   5.56   2.29   2.38  0000.00.00.0030100       45300 25.5217 090 99      0.00   0.00   0.00
45307  Proctosigmoidoscopy fb                            A   1.70   4.01     4.24     0.93     1.07     0.33   6.04   6.27   2.96   3.10  0000.00.00.0030000       45300 25.5217 090 99      0.00   0.00   0.00
45308  Proctosigmoidoscopy removal                       A   1.40   4.01     4.37     0.85     0.98     0.26   5.67   6.03   2.51   2.64  0000.00.00.0030100       45300 25.5217 090 99      0.00   0.00   0.00
45309  Proctosigmoidoscopy removal                       A   1.50   4.28     4.45     0.97     1.03     0.27   6.05   6.22   2.74   2.80  0000.00.00.0030100       45300 25.5217 090 99      0.00   0.00   0.00
45315  Proctosigmoidoscopy removal                       A   1.80   4.57     4.86     1.07     1.14     0.33   6.70   6.99   3.20   3.27  0000.00.00.0030100       45300 25.5217 090 99      0.00   0.00   0.00
45317  Proctosigmoidoscopy bleed                         A   2.00   4.13     4.44     1.08     1.23     0.33   6.46   6.77   3.41   3.56  0000.00.00.0030100       45300 25.5217 090 99      0.00   0.00   0.00
45320  Proctosigmoidoscopy ablate                        A   1.78   4.19     4.26     1.08     1.15     0.31   6.28   6.35   3.17   3.24  0000.00.00.0030100       45300 25.5217 090 99      0.00   0.00   0.00
45321  Proctosigmoidoscopy volvul                        A   1.75   1.07NA   1.17NA   1.07     1.17     0.33   3.15   3.25   3.15   3.25  0000.00.00.0030100       45300 25.5217 090 99      0.00   0.00   0.00
45327  Proctosigmoidoscopy w/stent                       A   2.00   1.32NA   1.45NA   1.32     1.45     0.42   3.74   3.87   3.74   3.87  0000.00.00.0030100       45300 25.5217 090 99      0.00   0.00   0.00
45330  Diagnostic sigmoidoscopy                          A   0.96   2.96     2.93     0.77     0.80     0.14   4.06   4.03   1.87   1.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
45331  Sigmoidoscopy and biopsy                          A   1.15   3.73     3.57     0.93     0.94     0.18   5.06   4.90   2.26   2.27  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45332  Sigmoidoscopy w/fb removal                        A   1.79   6.38     6.25     1.23     1.27     0.29   8.46   8.33   3.31   3.35  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45333  Sigmoidoscopy & polypectomy                       A   1.79   6.47     6.37     1.21     1.24     0.29   8.55   8.45   3.29   3.32  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45334  Sigmoidoscopy for bleeding                        A   2.73   1.80NA   1.80NA   1.80     1.80     0.39   4.92   4.92   4.92   4.92  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45335  Sigmoidoscopy w/submuc inj                        A   1.46   5.77     5.81     1.07     1.09     0.23   7.46   7.50   2.76   2.78  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45337  Sigmoidoscopy & decompress                        A   2.36   1.52NA   1.56NA   1.52     1.56     0.38   4.26   4.30   4.26   4.30  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45338  Sigmoidoscopy w/tumr remove                       A   2.34   6.68     6.47     1.54     1.56     0.35   9.37   9.16   4.23   4.25  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45339  Sigmoidoscopy w/ablate tumr                       A   3.14   6.25     6.28     1.98     2.00     0.48   9.87   9.90   5.60   5.62  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45340  Sig w/balloon dilation                            A   1.89  11.23    11.33     1.27     1.31     0.30  13.42  13.52   3.46   3.50  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45341  Sigmoidoscopy w/ultrasound                        A   2.60   1.73NA   1.74NA   1.73     1.74     0.38   4.71   4.72   4.71   4.72  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
45342  Sigmoidoscopy w/us guide bx                       A   4.05   2.55NA   2.57NA   2.55     2.57     0.60   7.20   7.22   7.20   7.22  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
45345  Sigmoidoscopy w/stent                             A   2.92   1.88NA   1.90NA   1.88     1.90     0.43   5.23   5.25   5.23   5.25  0000.00.00.0030100       45330 25.5217 090 99      0.00   0.00   0.00
45355  Surgical colonoscopy                              A   3.51   1.99NA   2.10NA   1.99     2.10     0.58   6.08   6.19   6.08   6.19  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
45378  Diagnostic colonoscopy                            A   3.69   7.41     7.15     2.23     2.27     0.58  11.68  11.42   6.50   6.54  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
4537853Diagnostic colonoscopy                            A   0.96   2.96     2.93     0.77     0.80     0.14   4.06   4.03   1.87   1.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
45379  Colonoscopy w/fb removal                          A   4.68   9.50     9.27     2.74     2.83     0.72  14.90  14.67   8.14   8.23  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45380  Colonoscopy and biopsy                            A   4.43   8.86     8.51     2.70     2.73     0.67  13.96  13.61   7.80   7.83  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45381  Colonoscopy submucous inj                         A   4.19   8.76     8.39     2.58     2.60     0.62  13.57  13.20   7.39   7.41  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45382  Colonoscopy/control bleeding                      A   5.68  11.76    11.16     3.43     3.44     0.84  18.28  17.68   9.95   9.96  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45383  Lesion removal colonoscopy                        A   5.86   9.99     9.79     3.29     3.39     0.91  16.76  16.56  10.06  10.16  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45384  Lesion remove colonoscopy                         A   4.69   8.39     8.19     2.71     2.77     0.73  13.81  13.61   8.13   8.19  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45385  Lesion removal colonoscopy                        A   5.30   9.63     9.27     3.15     3.19     0.80  15.73  15.37   9.25   9.29  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45386  Colonoscopy dilate stricture                      A   4.57  14.23    13.60     2.69     2.74     0.72  19.52  18.89   7.98   8.03  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45387  Colonoscopy w/stent                               A   5.90   3.58NA   3.64NA   3.58     3.64     0.88  10.36  10.42  10.36  10.42  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45391  Colonoscopy w/endoscope us                        A   5.09   3.08NA   3.10NA   3.08     3.10     0.73   8.90   8.92   8.90   8.92  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45392  Colonoscopy w/endoscopic fnb                      A   6.54   3.86NA   3.90NA   3.86     3.90     1.02  11.42  11.46  11.42  11.46  0000.00.00.0030100       45378 25.5217 090 99      0.00   0.00   0.00
45395  Lap removal of rectum                             A  33.00  18.73NA  20.67NA  18.73    20.67     5.98  57.71  59.65  57.71  59.65  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45397  Lap remove rectum w/pouch                         A  36.50  19.73NA  22.03NA  19.73    22.03     6.00  62.23  64.53  62.23  64.53  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45400  Laparoscopic proc                                 A  19.44  10.40NA  11.55NA  10.40    11.55     3.56  33.40  34.55  33.40  34.55  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45402  Lap proctopexy w/sig resect                       A  26.51  13.12NA  14.64NA  13.12    14.64     4.81  44.44  45.96  44.44  45.96  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45499  Laparoscope proc rectum                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
45500  Repair of rectum                                  A   7.73   5.95NA   6.62NA   5.95     6.62     1.21  14.89  15.56  14.89  15.56  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
45505  Repair of rectum                                  A   8.36   6.81NA   7.63NA   6.81     7.63     1.51  16.68  17.50  16.68  17.50  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
45520  Treatment of rectal prolapse                      A   0.55   3.43     3.75     0.52     0.57     0.07   4.05   4.37   1.14   1.19  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
45540  Correct rectal prolapse                           A  18.12   9.37NA  10.43NA   9.37    10.43     3.11  30.60  31.66  30.60  31.66  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45541  Correct rectal prolapse                           A  14.85   9.23NA  10.31NA   9.23    10.31     2.58  26.66  27.74  26.66  27.74  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45550  Repair rectum/remove sigmoid                      A  24.80  13.09NA  14.66NA  13.09    14.66     4.47  42.36  43.93  42.36  43.93  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45560  Repair of rectocele                               A  11.50   7.18NA   7.56NA   7.18     7.56     1.79  20.47  20.85  20.47  20.85  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45562  Exploration/repair of rectum                      A  17.98  10.92NA  11.89NA  10.92    11.89     3.37  32.27  33.24  32.27  33.24  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45563  Exploration/repair of rectum                      A  26.38  15.30NA  17.05NA  15.30    17.05     5.62  47.30  49.05  47.30  49.05  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45800  Repair rect/bladder fistula                       A  20.31  11.54NA  11.96NA  11.54    11.96     3.38  35.23  35.65  35.23  35.65  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45805  Repair fistula w/colostomy                        A  23.32  13.69NA  15.22NA  13.69    15.22     4.97  41.98  43.51  41.98  43.51  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45820  Repair rectourethral fistula                      A  20.37  11.75NA  12.48NA  11.75    12.48     1.96  34.08  34.81  34.08  34.81  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45825  Repair fistula w/colostomy                        A  24.17  14.46NA  15.55NA  14.46    15.55     3.45  42.08  43.17  42.08  43.17  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
45900  Reduction of rectal prolapse                      A   2.99   2.23NA   2.44NA   2.23     2.44     0.56   5.78   5.99   5.78   5.99  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
45905  Dilation of anal sphincter                        A   2.35   2.09NA   2.23NA   2.09     2.23     0.41   4.85   4.99   4.85   4.99  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
45910  Dilation of rectal narrowing                      A   2.85   2.34NA   2.45NA   2.34     2.45     0.48   5.67   5.78   5.67   5.78  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
45915  Remove rectal obstruction                         A   3.19   5.45     5.73     2.73     2.94     0.52   9.16   9.44   6.44   6.65  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
45990  Surg dx exam anorectal                            A   1.80   1.02NA   1.10NA   1.02     1.10     0.31   3.13   3.21   3.13   3.21  0000.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
45999  Rectum surgery procedure                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
46020  Placement of seton                                A   3.00   4.09     4.52     3.04     3.37     0.54   7.63   8.06   6.58   6.91  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46030  Removal of rectal marker                          A   1.26   2.35     2.56     1.08     1.19     0.23   3.84   4.05   2.57   2.68  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
46040  Incision of rectal abscess                        A   5.37   8.35     9.00     5.28     5.73     1.05  14.77  15.42  11.70  12.15  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46045  Incision of rectal abscess                        A   5.87   5.15NA   5.72NA   5.15     5.72     1.17  12.19  12.76  12.19  12.76  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46050  Incision of anal abscess                          A   1.24   3.96     4.24     1.28     1.40     0.24   5.44   5.72   2.76   2.88  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46060  Incision of rectal abscess                        A   6.37   5.80NA   6.46NA   5.80     6.46     1.18  13.35  14.01  13.35  14.01  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46070  Incision of anal septum                           A   2.79   3.50NA   3.83NA   3.50     3.83     0.20   6.49   6.82   6.49   6.82  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
46080  Incision of anal sphincter                        A   2.52   3.89     4.22     1.58     1.74     0.49   6.90   7.23   4.59   4.75  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46083  Incise external hemorrhoid                        A   1.45   3.33     3.33     1.38     1.45     0.24   5.02   5.02   3.07   3.14  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46200  Removal of anal fissure                           A   3.59   7.72     8.49     4.79     5.24     0.62  11.93  12.70   9.00   9.45  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46220  Excise anal ext tag/papilla                       A   1.61   3.76     4.05     1.47     1.61     0.30   5.67   5.96   3.38   3.52  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46221  Ligation of hemorrhoid(s)                         A   2.36   4.62     5.00     2.62     2.84     0.41   7.39   7.77   5.39   5.61  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46230  Removal of anal tags                              A   2.62   4.50     4.83     1.85     2.04     0.48   7.60   7.93   4.95   5.14  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46250  Remove ext hem groups 2+                          A   4.25   7.70     8.25     3.84     4.19     0.81  12.76  13.31   8.90   9.25  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46255  Remove int/ext hem 1 group                        A   4.96   8.15     8.64     4.13     4.50     0.95  14.06  14.55  10.04  10.41  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46257  Remove in/ex hem grp & fiss                       A   5.76   5.04NA   5.61NA   5.04     5.61     1.07  11.87  12.44  11.87  12.44  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46258  Remove in/ex hem grp w/fistu                      A   6.41   5.46NA   6.09NA   5.46     6.09     1.37  13.24  13.87  13.24  13.87  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
46260  Remove in/ex hem groups 2+                        A   6.73   5.41NA   6.02NA   5.41     6.02     1.26  13.40  14.01  13.40  14.01  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46261  Remove in/ex hem grps & fiss                      A   7.76   5.84NA   6.51NA   5.84     6.51     1.39  14.99  15.66  14.99  15.66  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46262  Remove in/ex hem grps w/fist                      A   7.91   6.31NA   7.01NA   6.31     7.01     1.44  15.66  16.36  15.66  16.36  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46270  Remove anal fist subq                             A   4.92   8.09     8.77     5.07     5.61     0.98  13.99  14.67  10.97  11.51  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46275  Remove anal fist inter                            A   5.42   8.33     9.13     5.20     5.77     0.98  14.73  15.53  11.60  12.17  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46280  Remove anal fist complex                          A   6.39   5.64NA   6.29NA   5.64     6.29     1.13  13.16  13.81  13.16  13.81  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46285  Remove anal fist 2 stage                          A   5.42   8.14     9.09     5.17     5.80     0.91  14.47  15.42  11.50  12.13  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46288  Repair anal fistula                               A   7.81   6.31NA   7.04NA   6.31     7.04     1.33  15.45  16.18  15.45  16.18  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46320  Removal of hemorrhoid clot                        A   1.64   3.11     3.35     1.23     1.35     0.30   5.05   5.29   3.17   3.29  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46500  Injection into hemorrhoid(s)                      A   1.69   4.39     4.81     1.68     1.84     0.29   6.37   6.79   3.66   3.82  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46505  Chemodenervation anal musc                        A   3.18   4.29     4.60     3.04     3.33     0.58   8.05   8.36   6.80   7.09  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
46600  Diagnostic anoscopy                               A   0.55   1.80     1.86     0.51     0.57     0.08   2.43   2.49   1.14   1.20  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
46604  Anoscopy and dilation                             A   1.03  14.94    15.93     0.72     0.77     0.16  16.13  17.12   1.91   1.96  0000.00.00.0030100       46600 25.5217 090 99      0.00   0.00   0.00
46606  Anoscopy and biopsy                               A   1.20   4.84     4.95     0.78     0.87     0.23   6.27   6.38   2.21   2.30  0000.00.00.0030100       46600 25.5217 090 99      0.00   0.00   0.00
46608  Anoscopy remove for body                          A   1.30   4.93     5.11     0.80     0.86     0.24   6.47   6.65   2.34   2.40  0000.00.00.0030000       46600 25.5217 090 99      0.00   0.00   0.00
46610  Anoscopy remove lesion                            A   1.28   4.84     4.97     0.83     0.91     0.24   6.36   6.49   2.35   2.43  0000.00.00.0030100       46600 25.5217 090 99      0.00   0.00   0.00
46611  Anoscopy                                          A   1.30   3.43     3.57     0.85     0.93     0.23   4.96   5.10   2.38   2.46  0000.00.00.0030000       46600 25.5217 090 99      0.00   0.00   0.00
46612  Anoscopy remove lesions                           A   1.50   5.69     5.78     0.97     1.01     0.31   7.50   7.59   2.78   2.82  0000.00.00.0030000       46600 25.5217 090 99      0.00   0.00   0.00
46614  Anoscopy control bleeding                         A   1.00   2.49     2.50     0.76     0.78     0.14   3.63   3.64   1.90   1.92  0000.00.00.0030100       46600 25.5217 090 99      0.00   0.00   0.00
46615  Anoscopy                                          A   1.50   2.37     2.40     0.97     1.01     0.29   4.16   4.19   2.76   2.80  0000.00.00.0030000       46600 25.5217 090 99      0.00   0.00   0.00
46700  Repair of anal stricture                          A   9.81   7.08NA   7.96NA   7.08     7.96     1.63  18.52  19.40  18.52  19.40  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46705  Repair of anal stricture                          A   7.43   6.02NA   6.23NA   6.02     6.23     0.52  13.97  14.18  13.97  14.18  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46706  Repr of anal fistula w/glue                       A   2.44   1.95NA   2.09NA   1.95     2.09     0.42   4.81   4.95   4.81   4.95  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46707  Repair anorectal fist w/plug                      A   6.39   6.52NA   6.52NA   6.52     6.52     0.90  13.81  13.81  13.81  13.81  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
46710  Repr per/vag pouch sngl proc                      A  17.14  10.81NA  11.59NA  10.81    11.59     3.67  31.62  32.40  31.62  32.40  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46712  Repr per/vag pouch dbl proc                       A  36.45  19.99NA  22.21NA  19.99    22.21     2.58  59.02  61.24  59.02  61.24  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46715  Rep perf anoper fistu                             A   7.62   5.87NA   6.38NA   5.87     6.38     0.53  14.02  14.53  14.02  14.53  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
46716  Rep perf anoper/vestib fistu                      A  17.54  14.51NA  13.80NA  14.51    13.80     1.24  33.29  32.58  33.29  32.58  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46730  Construction of absent anus                       A  30.65  18.50NA  19.25NA  18.50    19.25     2.17  51.32  52.07  51.32  52.07  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46735  Construction of absent anus                       A  36.14  20.80NA  21.67NA  20.80    21.67     2.57  59.51  60.38  59.51  60.38  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46740  Construction of absent anus                       A  33.90  20.28NA  22.59NA  20.28    22.59     7.21  61.39  63.70  61.39  63.70  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46742  Repair of imperforated anus                       A  40.14  22.99NA  25.22NA  22.99    25.22     8.54  71.67  73.90  71.67  73.90  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46744  Repair of cloacal anomaly                         A  58.94  30.59NA  35.38NA  30.59    35.38     8.41  97.94 102.73  97.94 102.73  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46746  Repair of cloacal anomaly                         A  65.44  33.69NA  34.70NA  33.69    34.70     4.63 103.76 104.77 103.76 104.77  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46748  Repair of cloacal anomaly                         A  71.42  33.79NA  33.57NA  33.79    33.57     5.07 110.28 110.06 110.28 110.06  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46750  Repair of anal sphincter                          A  12.15   7.87NA   8.64NA   7.87     8.64     1.97  21.99  22.76  21.99  22.76  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46751  Repair of anal sphincter                          A   9.30   6.92NA   6.98NA   6.92     6.98     1.56  17.78  17.84  17.78  17.84  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46753  Reconstruction of anus                            A   8.89   6.31NA   7.00NA   6.31     7.00     1.51  16.71  17.40  16.71  17.40  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46754  Removal of suture from anus                       A   3.01   4.88     5.22     3.02     3.40     0.42   8.31   8.65   6.45   6.83  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
46760  Repair of anal sphincter                          A  17.45  11.16NA  12.54NA  11.16    12.54     2.47  31.08  32.46  31.08  32.46  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46761  Repair of anal sphincter                          A  15.29   9.13NA  10.19NA   9.13    10.19     2.42  26.84  27.90  26.84  27.90  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46762  Implant artificial sphincter                      A  14.82   9.46NA  10.48NA   9.46    10.48     2.12  26.40  27.42  26.40  27.42  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
46900  Destruction anal lesion(s)                        A   1.91   4.47     4.76     1.77     1.90     0.30   6.68   6.97   3.98   4.11  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46910  Destruction anal lesion(s)                        A   1.91   4.70     4.90     1.59     1.71     0.34   6.95   7.15   3.84   3.96  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46916  Cryosurgery anal lesion(s)                        A   1.91   4.53     4.56     2.05     2.16     0.27   6.71   6.74   4.23   4.34  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46917  Laser surgery anal lesions                        A   1.91  10.89    10.96     1.62     1.74     0.33  13.13  13.20   3.86   3.98  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46922  Excision of anal lesion(s)                        A   1.91   5.08     5.39     1.60     1.75     0.35   7.34   7.65   3.86   4.01  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46924  Destruction anal lesion(s)                        A   2.81  11.73    12.04     2.06     2.25     0.45  14.99  15.30   5.32   5.51  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46930  Destroy internal hemorrhoids                      A   1.61   4.14     3.94     2.49     2.41     0.26   6.01   5.81   4.36   4.28  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
46940  Treatment of anal fissure                         A   2.35   3.59     3.94     1.49     1.65     0.37   6.31   6.66   4.21   4.37  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
46942  Treatment of anal fissure                         A   2.07   3.50     3.85     1.37     1.52     0.33   5.90   6.25   3.77   3.92  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
46945  Remove by ligat int hem grp                       A   2.21   5.76     6.17     3.70     3.93     0.38   8.35   8.76   6.29   6.52  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46946  Remove by ligat int hem grps                      A   2.63   5.62     5.87     3.33     3.49     0.43   8.68   8.93   6.39   6.55  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46947  Hemorrhoidopexy by stapling                       A   5.57   4.23NA   4.68NA   4.23     4.68     1.09  10.89  11.34  10.89  11.34  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
46999  Anus surgery procedure                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
47000  Needle biopsy of liver                            A   1.90   8.09     8.20     0.82     0.74     0.20  10.19  10.30   2.92   2.84  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
47001  Needle biopsy liver add-on                        A   1.90   0.75NA   0.82NA   0.75     0.82     0.38   3.03   3.10   3.03   3.10  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
47010  Open drainage liver lesion                        A  19.40  11.36NA  12.19NA  11.36    12.19     3.95  34.71  35.54  34.71  35.54  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47011  Percut drain liver lesion                         A   3.69   1.54NA   1.36NA   1.54     1.36     0.35   5.58   5.40   5.58   5.40  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
47015  Inject/aspirate liver cyst                        A  18.50  10.98NA  12.17NA  10.98    12.17     3.92  33.40  34.59  33.40  34.59  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47100  Wedge biopsy of liver                             A  12.91   8.67NA   9.48NA   8.67     9.48     2.69  24.27  25.08  24.27  25.08  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47120  Partial removal of liver                          A  39.01  20.23NA  22.18NA  20.23    22.18     8.24  67.48  69.43  67.48  69.43  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47122  Extensive removal of liver                        A  59.48  27.65NA  30.30NA  27.65    30.30    12.62  99.75 102.40  99.75 102.40  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47125  Partial removal of liver                          A  53.04  25.09NA  27.49NA  25.09    27.49    11.18  89.31  91.71  89.31  91.71  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47130  Partial removal of liver                          A  57.19  26.67NA  29.16NA  26.67    29.16    12.02  95.88  98.37  95.88  98.37  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47133  Removal of donor liver                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
47135  Transplantation of liver                          R  83.64  40.79NA  44.88NA  40.79    44.88    17.67 142.10 146.19 142.10 146.19  0090.09.81.1020212             25.5217 090 99      0.00   0.00   0.00
47136  Transplantation of liver                          R  70.74  34.87NA  37.60NA  34.87    37.60    15.06 120.67 123.40 120.67 123.40  0090.09.81.1020212             25.5217 090 99      0.00   0.00   0.00
47140  Partial removal donor liver                       A  59.40  31.12NA  34.45NA  31.12    34.45    12.64 103.16 106.49 103.16 106.49  0090.09.81.1020212             25.5217 090 99      0.00   0.00   0.00
47141  Partial removal donor liver                       A  71.50  35.66NA  38.50NA  35.66    38.50     5.07 112.23 115.07 112.23 115.07  0090.09.81.1020212             25.5217 090 99      0.00   0.00   0.00
47142  Partial removal donor liver                       A  79.44  39.87NA  44.07NA  39.87    44.07    16.89 136.20 140.40 136.20 140.40  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47143  Prep donor liver whole                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
47144  Prep donor liver 3-segment                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47145  Prep donor liver lobe split                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
47146  Prep donor liver/venous                           A   6.00   2.38NA   2.62NA   2.38     2.62     1.28   9.66   9.90   9.66   9.90  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
47147  Prep donor liver/arterial                         A   7.00   2.78NA   3.06NA   2.78     3.06     1.48  11.26  11.54  11.26  11.54  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
47300  Surgery for liver lesion                          A  18.14  10.71NA  11.86NA  10.71    11.86     3.83  32.68  33.83  32.68  33.83  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47350  Repair liver wound                                A  22.49  12.50NA  13.72NA  12.50    13.72     4.69  39.68  40.90  39.68  40.90  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47360  Repair liver wound                                A  31.31  16.30NA  18.05NA  16.30    18.05     6.65  54.26  56.01  54.26  56.01  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47361  Repair liver wound                                A  52.60  24.42NA  26.72NA  24.42    26.72    10.67  87.69  89.99  87.69  89.99  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47362  Repair liver wound                                A  23.54  13.13NA  14.66NA  13.13    14.66     4.93  41.60  43.13  41.60  43.13  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47370  Laparo ablate liver tumor rf                      A  20.80  10.91NA  11.93NA  10.91    11.93     4.21  35.92  36.94  35.92  36.94  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47371  Laparo ablate liver cryosurg                      A  20.80  11.39NA  12.25NA  11.39    12.25     4.43  36.62  37.48  36.62  37.48  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47379  Laparoscope procedure liver                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
47380  Open ablate liver tumor rf                        A  24.56  12.35NA  13.38NA  12.35    13.38     4.94  41.85  42.88  41.85  42.88  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47381  Open ablate liver tumor cryo                      A  24.88  11.58NA  11.36NA  11.58    11.36     5.30  41.76  41.54  41.76  41.54  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47382  Percut ablate liver rf                            A  15.22 120.12   120.12     7.17     6.22     1.48 136.82 136.82  23.87  22.92  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
47399  Liver surgery procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020111             25.5217 090 99      0.00   0.00   0.00
47400  Incision of liver duct                            A  36.36  18.33NA  20.26NA  18.33    20.26     7.73  62.42  64.35  62.42  64.35  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47420  Incision of bile duct                             A  22.03  12.14NA  13.34NA  12.14    13.34     4.66  38.83  40.03  38.83  40.03  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47425  Incision of bile duct                             A  22.31  12.35NA  13.69NA  12.35    13.69     4.75  39.41  40.75  39.41  40.75  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47460  Incise bile duct sphincter                        A  20.52  12.10NA  12.91NA  12.10    12.91     4.36  36.98  37.79  36.98  37.79  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47480  Incision of gallbladder                           A  13.25   9.03NA   9.90NA   9.03     9.90     2.74  25.02  25.89  25.02  25.89  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47490  Incision of gallbladder                           A   4.76   5.57NA   4.32NA   5.57     4.32     0.43  10.76   9.51  10.76   9.51  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
47500  Injection for liver x-rays                        A   1.96   0.82NA   0.71NA   0.82     0.71     0.20   2.98   2.87   2.98   2.87  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
47505  Injection for liver x-rays                        A   0.76   0.32NA   0.28NA   0.32     0.28     0.07   1.15   1.11   1.15   1.11  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
47510  Insert catheter bile duct                         A   8.03   5.46NA   4.88NA   5.46     4.88     0.80  14.29  13.71  14.29  13.71  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
47511  Insert bile duct drain                            A  10.77   5.89NA   5.16NA   5.89     5.16     1.02  17.68  16.95  17.68  16.95  0090.09.81.1021100             25.5217 090 99      0.00   0.00   0.00
47525  Change bile duct catheter                         A   1.54  13.52    12.36     1.23     0.81     0.14  15.20  14.04   2.91   2.49  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
47530  Revise/reinsert bile tube                         A   6.05  36.11    33.64     4.09     3.65     0.61  42.77  40.30  10.75  10.31  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
47550  Bile duct endoscopy add-on                        A   3.02   1.21NA   1.32NA   1.21     1.32     0.62   4.85   4.96   4.85   4.96  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
47552  Biliary endoscopy thru skin                       A   6.03   2.94NA   2.60NA   2.94     2.60     0.62   9.59   9.25   9.59   9.25  0000.00.00.0020110             25.5217 090 99      0.00   0.00   0.00
47553  Biliary endoscopy thru skin                       A   6.34   2.63NA   2.34NA   2.63     2.34     0.62   9.59   9.30   9.59   9.30  0000.00.00.0030100       47552 25.5217 090 99      0.00   0.00   0.00
47554  Biliary endoscopy thru skin                       A   9.05   4.16NA   4.07NA   4.16     4.07     1.51  14.72  14.63  14.72  14.63  0000.00.00.0030110       47552 25.5217 090 99      0.00   0.00   0.00
47555  Biliary endoscopy thru skin                       A   7.55   3.14NA   2.72NA   3.14     2.72     0.71  11.40  10.98  11.40  10.98  0000.00.00.0030100       47552 25.5217 090 99      0.00   0.00   0.00
47556  Biliary endoscopy thru skin                       A   8.55   3.57NA   3.10NA   3.57     3.10     0.80  12.92  12.45  12.92  12.45  0000.00.00.0030100       47552 25.5217 090 99      0.00   0.00   0.00
47560  Laparoscopy w/cholangio                           A   4.88   1.96NA   2.13NA   1.96     2.13     1.05   7.89   8.06   7.89   8.06  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
47561  Laparo w/cholangio/biopsy                         A   5.17   2.34NA   2.55NA   2.34     2.55     1.10   8.61   8.82   8.61   8.82  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
47562  Laparoscopic cholecystectomy                      A  11.76   7.32NA   8.08NA   7.32     8.08     2.47  21.55  22.31  21.55  22.31  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47563  Laparo cholecystectomy/graph                      A  12.11   7.17NA   7.86NA   7.17     7.86     2.57  21.85  22.54  21.85  22.54  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47564  Laparo cholecystectomy/explr                      A  14.24   7.77NA   8.49NA   7.77     8.49     3.03  25.04  25.76  25.04  25.76  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47570  Laparo cholecystoenterostomy                      A  12.56   7.18NA   7.86NA   7.18     7.86     2.66  22.40  23.08  22.40  23.08  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47579  Laparoscope proc biliary                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
47600  Removal of gallbladder                            A  17.48   9.98NA  11.15NA   9.98    11.15     3.69  31.15  32.32  31.15  32.32  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47605  Removal of gallbladder                            A  15.98   9.02NA   9.92NA   9.02     9.92     3.40  28.40  29.30  28.40  29.30  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47610  Removal of gallbladder                            A  20.92  10.96NA  12.08NA  10.96    12.08     4.44  36.32  37.44  36.32  37.44  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47612  Removal of gallbladder                            A  21.21  11.02NA  12.15NA  11.02    12.15     4.49  36.72  37.85  36.72  37.85  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47620  Removal of gallbladder                            A  23.07  11.90NA  13.18NA  11.90    13.18     4.93  39.90  41.18  39.90  41.18  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47630  Remove bile duct stone                            A   9.65   5.71NA   5.27NA   5.71     5.27     1.21  16.57  16.13  16.57  16.13  0090.09.81.1020110             25.5217 090 99      0.00   0.00   0.00
47700  Exploration of bile ducts                         A  16.50  10.34NA  11.28NA  10.34    11.28     3.52  30.36  31.30  30.36  31.30  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47701  Bile duct revision                                A  28.73  16.21NA  16.91NA  16.21    16.91     6.10  51.04  51.74  51.04  51.74  0090.09.81.1020000             25.5217 090 99      0.00   0.00   0.00
47711  Excision of bile duct tumor                       A  25.90  13.78NA  15.17NA  13.78    15.17     5.47  45.15  46.54  45.15  46.54  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47712  Excision of bile duct tumor                       A  33.72  16.96NA  18.82NA  16.96    18.82     7.18  57.86  59.72  57.86  59.72  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47715  Excision of bile duct cyst                        A  21.55  12.14NA  13.50NA  12.14    13.50     4.59  38.28  39.64  38.28  39.64  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47720  Fuse gallbladder & bowel                          A  18.34  10.81NA  11.91NA  10.81    11.91     3.87  33.02  34.12  33.02  34.12  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47721  Fuse upper gi structures                          A  21.99  12.33NA  13.70NA  12.33    13.70     4.69  39.01  40.38  39.01  40.38  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47740  Fuse gallbladder & bowel                          A  21.23  12.00NA  13.36NA  12.00    13.36     4.51  37.74  39.10  37.74  39.10  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47741  Fuse gallbladder & bowel                          A  24.21  13.22NA  14.67NA  13.22    14.67     5.15  42.58  44.03  42.58  44.03  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47760  Fuse bile ducts and bowel                         A  38.32  18.53NA  21.00NA  18.53    21.00     8.09  64.94  67.41  64.94  67.41  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47765  Fuse liver ducts & bowel                          A  52.19  23.85NA  27.60NA  23.85    27.60    11.11  87.15  90.90  87.15  90.90  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47780  Fuse bile ducts and bowel                         A  42.32  19.92NA  22.63NA  19.92    22.63     8.96  71.20  73.91  71.20  73.91  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47785  Fuse bile ducts and bowel                         A  56.19  25.19NA  28.92NA  25.19    28.92    11.96  93.34  97.07  93.34  97.07  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47800  Reconstruction of bile ducts                      A  26.17  13.99NA  15.49NA  13.99    15.49     5.58  45.74  47.24  45.74  47.24  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47801  Placement bile duct support                       A  17.60  10.40NA  10.00NA  10.40    10.00     2.43  30.43  30.03  30.43  30.03  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47802  Fuse liver duct & intestine                       A  24.93  13.79NA  15.27NA  13.79    15.27     5.31  44.03  45.51  44.03  45.51  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47900  Suture bile duct injury                           A  22.44  12.29NA  13.49NA  12.29    13.49     4.71  39.44  40.64  39.44  40.64  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
47999  Bile tract surgery procedure                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020111             25.5217 090 99      0.00   0.00   0.00
48000  Drainage of abdomen                               A  31.95  15.69NA  16.98NA  15.69    16.98     6.17  53.81  55.10  53.81  55.10  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48001  Placement of drain pancreas                       A  39.69  18.88NA  20.93NA  18.88    20.93     8.46  67.03  69.08  67.03  69.08  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48020  Removal of pancreatic stone                       A  19.09  10.83NA  11.93NA  10.83    11.93     4.07  33.99  35.09  33.99  35.09  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48100  Biopsy of pancreas open                           A  14.46   8.20NA   9.00NA   8.20     9.00     2.99  25.65  26.45  25.65  26.45  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48102  Needle biopsy pancreas                            A   4.70  10.82    10.25     2.25     1.98     0.43  15.95  15.38   7.38   7.11  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
48105  Resect/debride pancreas                           A  49.26  23.20NA  25.85NA  23.20    25.85    10.28  82.74  85.39  82.74  85.39  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48120  Removal of pancreas lesion                        A  18.41   9.73NA  10.73NA   9.73    10.73     3.90  32.04  33.04  32.04  33.04  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48140  Partial removal of pancreas                       A  26.32  13.39NA  14.77NA  13.39    14.77     5.57  45.28  46.66  45.28  46.66  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48145  Partial removal of pancreas                       A  27.39  13.96NA  15.56NA  13.96    15.56     5.81  47.16  48.76  47.16  48.76  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48146  Pancreatectomy                                    A  30.60  17.00NA  18.92NA  17.00    18.92     6.50  54.10  56.02  54.10  56.02  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48148  Removal of pancreatic duct                        A  20.39  11.23NA  12.50NA  11.23    12.50     4.33  35.95  37.22  35.95  37.22  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48150  Partial removal of pancreas                       A  52.84  26.02NA  28.53NA  26.02    28.53    11.20  90.06  92.57  90.06  92.57  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48152  Pancreatectomy                                    A  48.65  24.63NA  27.23NA  24.63    27.23    10.36  83.64  86.24  83.64  86.24  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48153  Pancreatectomy                                    A  52.79  25.96NA  28.51NA  25.96    28.51    11.19  89.94  92.49  89.94  92.49  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48154  Pancreatectomy                                    A  48.88  24.63NA  27.33NA  24.63    27.33    10.40  83.91  86.61  83.91  86.61  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48155  Removal of pancreas                               A  29.45  16.69NA  18.34NA  16.69    18.34     6.26  52.40  54.05  52.40  54.05  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48160  Pancreas removal/transplant                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
48400  Injection intraop add-on                          A   1.95   0.86NA   0.85NA   0.86     0.85     0.29   3.10   3.09   3.10   3.09  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
48500  Surgery of pancreatic cyst                        A  18.16  11.03NA  12.23NA  11.03    12.23     3.86  33.05  34.25  33.05  34.25  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48510  Drain pancreatic pseudocyst                       A  17.19  10.53NA  11.56NA  10.53    11.56     3.59  31.31  32.34  31.31  32.34  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48511  Drain pancreatic pseudocyst                       A   3.99  23.46    21.85     1.68     1.48     0.38  27.83  26.22   6.05   5.85  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
48520  Fuse pancreas cyst and bowel                      A  18.15   9.67NA  10.64NA   9.67    10.64     3.83  31.65  32.62  31.65  32.62  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48540  Fuse pancreas cyst and bowel                      A  21.94  10.95NA  11.97NA  10.95    11.97     4.66  37.55  38.57  37.55  38.57  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48545  Pancreatorrhaphy                                  A  22.23  11.76NA  13.18NA  11.76    13.18     4.74  38.73  40.15  38.73  40.15  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48547  Duodenal exclusion                                A  30.38  14.98NA  16.74NA  14.98    16.74     6.45  51.81  53.57  51.81  53.57  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48548  Fuse pancreas and bowel                           A  28.09  14.21NA  15.64NA  14.21    15.64     5.96  48.26  49.69  48.26  49.69  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
48550  Donor pancreatectomy                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
48551  Prep donor pancreas                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
48552  Prep donor pancreas/venous                        A   4.30   1.73NA   1.88NA   1.73     1.88     0.90   6.93   7.08   6.93   7.08  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
48554  Transpl allograft pancreas                        R  37.80  27.65NA  30.15NA  27.65    30.15     7.88  73.33  75.83  73.33  75.83  0090.09.81.1020222             25.5217 090 99      0.00   0.00   0.00
48556  Removal allograft pancreas                        A  19.47  12.84NA  14.12NA  12.84    14.12     4.14  36.45  37.73  36.45  37.73  0090.09.81.1020222             25.5217 090 99      0.00   0.00   0.00
48999  Pancreas surgery procedure                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
49000  Exploration of abdomen                            A  12.54   7.26NA   7.85NA   7.26     7.85     2.57  22.37  22.96  22.37  22.96  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49002  Reopening of abdomen                              A  17.63   8.85NA   9.96NA   8.85     9.96     3.65  30.13  31.24  30.13  31.24  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49010  Exploration behind abdomen                        A  16.06   8.38NA   8.90NA   8.38     8.90     3.19  27.63  28.15  27.63  28.15  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49020  Drain abdominal abscess                           A  26.67  14.06NA  15.41NA  14.06    15.41     5.40  46.13  47.48  46.13  47.48  0090.09.81.1020200             25.5217 090 99      0.00   0.00   0.00
49021  Drain abdominal abscess                           A   3.37  22.81    21.10     1.41     1.24     0.31  26.49  24.78   5.09   4.92  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
49040  Drain open abdom abscess                          A  16.52   9.12NA   9.99NA   9.12     9.99     3.38  29.02  29.89  29.02  29.89  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49041  Drain percut abdom abscess                        A   3.99  22.93    21.53     1.66     1.46     0.38  27.30  25.90   6.03   5.83  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
49060  Drain open retrop abscess                         A  18.53   9.94NA  10.59NA   9.94    10.59     3.68  32.15  32.80  32.15  32.80  0090.09.81.1020110             25.5217 090 99      0.00   0.00   0.00
49061  Drain percut retroper absc                        A   3.69  22.69    21.18     1.54     1.36     0.34  26.72  25.21   5.57   5.39  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
49062  Drain to peritoneal cavity                        A  12.22   7.08NA   7.50NA   7.08     7.50     2.46  21.76  22.18  21.76  22.18  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49080  Puncture peritoneal cavity                        A   1.35   3.35     2.97     0.58     0.53     0.12   4.82   4.44   2.05   2.00  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
49081  Removal of abdominal fluid                        A   1.26   3.40     3.32     0.58     0.57     0.16   4.82   4.74   2.00   1.99  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
49180  Biopsy abdominal mass                             A   1.73   2.96     2.64     0.72     0.64     0.16   4.85   4.53   2.61   2.53  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
49203  Exc abd tum 5 cm or less                          A  20.13  10.74NA  11.59NA  10.74    11.59     3.92  34.79  35.64  34.79  35.64  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49204  Exc abd tum over 5 cm                             A  26.13  13.12NA  14.20NA  13.12    14.20     5.07  44.32  45.40  44.32  45.40  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49205  Exc abd tum over 10 cm                            A  30.13  14.72NA  15.97NA  14.72    15.97     6.02  50.87  52.12  50.87  52.12  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49215  Excise sacral spine tumor                         A  37.81  18.77NA  20.79NA  18.77    20.79     7.52  64.10  66.12  64.10  66.12  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49220  Multiple surgery abdomen                          A  15.79   8.96NA   9.77NA   8.96     9.77     3.38  28.13  28.94  28.13  28.94  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49250  Excision of umbilicus                             A   9.01   6.00NA   6.52NA   6.00     6.52     1.83  16.84  17.36  16.84  17.36  0090.09.81.1020110             25.5217 090 99      0.00   0.00   0.00
49255  Removal of omentum                                A  12.56   7.74NA   8.38NA   7.74     8.38     2.54  22.84  23.48  22.84  23.48  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49320  Diag laparo separate proc                         A   5.14   3.35NA   3.57NA   3.35     3.57     1.03   9.52   9.74   9.52   9.74  0010.10.80.1020200             25.5217 090 99      0.00   0.00   0.00
49321  Laparoscopy biopsy                                A   5.44   3.51NA   3.77NA   3.51     3.77     1.13  10.08  10.34  10.08  10.34  0010.10.80.1030220       49320 25.5217 090 99      0.00   0.00   0.00
49322  Laparoscopy aspiration                            A   6.01   3.67NA   3.89NA   3.67     3.89     1.15  10.83  11.05  10.83  11.05  0010.10.80.1030220       49320 25.5217 090 99      0.00   0.00   0.00
49323  Laparo drain lymphocele                           A  10.23   6.38NA   6.91NA   6.38     6.91     2.13  18.74  19.27  18.74  19.27  0090.10.80.1030220       49320 25.5217 090 99      0.00   0.00   0.00
49324  Lap insert tunnel ip cath                         A   6.32   3.82NA   4.13NA   3.82     4.13     1.33  11.47  11.78  11.47  11.78  0010.10.80.1030220       49320 25.5217 090 99      0.00   0.00   0.00
49325  Lap revision perm ip cath                         A   6.82   3.99NA   4.32NA   3.99     4.32     1.47  12.28  12.61  12.28  12.61  0010.10.80.1030220       49320 25.5217 090 99      0.00   0.00   0.00
49326  Lap w/omentopexy add-on                           A   3.50   1.32NA   1.47NA   1.32     1.47     0.73   5.55   5.70   5.55   5.70  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
49327  Lap ins device for rt                             A   2.38   1.04NA   1.04NA   1.04     1.04     0.48   3.90   3.90   3.90   3.90  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
49329  Laparo proc abdm/per/oment                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
49400  Air injection into abdomen                        A   1.88   2.53     1.81     0.77     0.70     0.24   4.65   3.93   2.89   2.82  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
49402  Remove foreign body adbomen                       A  14.09   7.81NA   8.57NA   7.81     8.57     2.89  24.79  25.55  24.79  25.55  0090.09.81.1020110             25.5217 090 99      0.00   0.00   0.00
49411  Ins mark abd/pel for rt perq                      A   3.82  11.25    11.25     1.66     1.66     0.35  15.42  15.42   5.83   5.83  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49412  Ins device for rt guide open                      A   1.50   0.63NA   0.63NA   0.63     0.63     0.30   2.43   2.43   2.43   2.43  0ZZZ.00.00.0000010             25.5217 090 99      0.00   0.00   0.00
49418  Insert tun ip cath perc                           A   4.21  40.03    40.03     2.07     2.07     0.62  44.86  44.86   6.90   6.90  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49419  Insert tun ip cath w/port                         A   7.08   4.61NA   4.81NA   4.61     4.81     1.22  12.91  13.11  12.91  13.11  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
49421  Ins tun ip cath for dial opn                      A   4.21   2.90NA   1.91NA   2.90     1.91     0.83   7.94   6.95   7.94   6.95  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
49422  Remove tunneled ip cath                           A   6.29   3.63NA   3.84NA   3.63     3.84     1.29  11.21  11.42  11.21  11.42  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
49423  Exchange drainage catheter                        A   1.46  15.28    14.18     0.65     0.56     0.12  16.86  15.76   2.23   2.14  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49424  Assess cyst contrast inject                       A   0.76   3.66     3.34     0.35     0.31     0.07   4.49   4.17   1.18   1.14  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49425  Insert abdomen-venous drain                       A  12.22   7.21NA   7.57NA   7.21     7.57     2.66  22.09  22.45  22.09  22.45  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49426  Revise abdomen-venous shunt                       A  10.41   6.16NA   6.47NA   6.16     6.47     2.06  18.63  18.94  18.63  18.94  0090.09.81.1020100             25.5217 090 99      0.00   0.00   0.00
49427  Injection abdominal shunt                         A   0.89   0.38NA   0.34NA   0.38     0.34     0.10   1.37   1.33   1.37   1.33  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49428  Ligation of shunt                                 A   6.87   4.36NA   4.52NA   4.36     4.52     1.47  12.70  12.86  12.70  12.86  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
49429  Removal of shunt                                  A   7.44   4.32NA   4.65NA   4.32     4.65     1.59  13.35  13.68  13.35  13.68  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
49435  Insert subq exten to ip cath                      A   2.25   0.81NA   0.89NA   0.81     0.89     0.45   3.51   3.59   3.51   3.59  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
49436  Embedded ip cath exit-site                        A   2.72   2.10NA   2.22NA   2.10     2.22     0.58   5.40   5.52   5.40   5.52  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
49440  Place gastrostomy tube perc                       A   4.18  27.53    25.13     2.17     2.01     0.48  32.19  29.79   6.83   6.67  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
49441  Place duod/jej tube perc                          A   4.77  30.37    28.30     2.45     2.29     0.54  35.68  33.61   7.76   7.60  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
49442  Place cecostomy tube perc                         A   4.00  25.57    21.78     2.05     2.02     0.37  29.94  26.15   6.42   6.39  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
49446  Change g-tube to g-j perc                         A   3.31  26.15    24.26     1.39     1.22     0.31  29.77  27.88   5.01   4.84  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49450  Replace g/c tube perc                             A   1.36  19.76    17.15     0.55     0.52     0.12  21.24  18.63   2.03   2.00  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49451  Replace duod/jej tube perc                        A   1.84  19.47    18.30     0.78     0.69     0.20  21.51  20.34   2.82   2.73  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49452  Replace g-j tube perc                             A   2.86  23.61    21.94     1.21     1.06     0.27  26.74  25.07   4.34   4.19  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49460  Fix g/colon tube w/device                         A   0.96  22.38    19.55     0.40     0.38     0.10  23.44  20.61   1.46   1.44  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49465  Fluoro exam of g/colon tube                       A   0.62   4.44     4.14     0.26     0.23     0.05   5.11   4.81   0.93   0.90  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
49491  Rpr hern preemie reduc                            A  12.53   7.57NA   8.39NA   7.57     8.39     2.66  22.76  23.58  22.76  23.58  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49492  Rpr ing hern premie blocked                       A  15.43   8.86NA   9.75NA   8.86     9.75     3.29  27.58  28.47  27.58  28.47  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49495  Rpr ing hernia baby reduc                         A   6.20   4.13NA   4.64NA   4.13     4.64     1.32  11.65  12.16  11.65  12.16  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49496  Rpr ing hernia baby blocked                       A   9.42   6.17NA   6.80NA   6.17     6.80     2.20  17.79  18.42  17.79  18.42  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49500  Rpr ing hernia init reduce                        A   5.84   4.01NA   3.96NA   4.01     3.96     1.24  11.09  11.04  11.09  11.04  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49501  Rpr ing hernia init blocked                       A   9.36   6.02NA   6.62NA   6.02     6.62     1.98  17.36  17.96  17.36  17.96  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49505  Prp i/hern init reduc >5 yr                       A   7.96   5.33NA   5.82NA   5.33     5.82     1.66  14.95  15.44  14.95  15.44  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49507  Prp i/hern init block >5 yr                       A  10.05   6.21NA   6.80NA   6.21     6.80     2.12  18.38  18.97  18.38  18.97  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49520  Rerepair ing hernia reduce                        A   9.99   6.13NA   6.70NA   6.13     6.70     2.09  18.21  18.78  18.21  18.78  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49521  Rerepair ing hernia blocked                       A  12.44   7.07NA   7.73NA   7.07     7.73     2.61  22.12  22.78  22.12  22.78  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49525  Repair ing hernia sliding                         A   8.93   5.70NA   6.23NA   5.70     6.23     1.86  16.49  17.02  16.49  17.02  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49540  Repair lumbar hernia                              A  10.74   6.51NA   7.17NA   6.51     7.17     2.25  19.50  20.16  19.50  20.16  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49550  Rpr rem hernia init reduce                        A   8.99   5.71NA   6.24NA   5.71     6.24     1.89  16.59  17.12  16.59  17.12  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49553  Rpr fem hernia init blocked                       A   9.92   6.16NA   6.76NA   6.16     6.76     2.09  18.17  18.77  18.17  18.77  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49555  Rerepair fem hernia reduce                        A   9.39   5.87NA   6.40NA   5.87     6.40     1.97  17.23  17.76  17.23  17.76  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49557  Rerepair fem hernia blocked                       A  11.62   6.84NA   7.49NA   6.84     7.49     2.44  20.90  21.55  20.90  21.55  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49560  Rpr ventral hern init reduc                       A  11.92   6.91NA   7.56NA   6.91     7.56     2.47  21.30  21.95  21.30  21.95  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49561  Rpr ventral hern init block                       A  15.38   8.29NA   9.13NA   8.29     9.13     3.23  26.90  27.74  26.90  27.74  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49565  Rerepair ventrl hern reduce                       A  12.37   7.22NA   7.93NA   7.22     7.93     2.59  22.18  22.89  22.18  22.89  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49566  Rerepair ventrl hern block                        A  15.53   8.39NA   9.24NA   8.39     9.24     3.29  27.21  28.06  27.21  28.06  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49568  Hernia repair w/mesh                              A   4.88   1.94NA   2.13NA   1.94     2.13     1.03   7.85   8.04   7.85   8.04  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
49570  Rpr epigastric hern reduce                        A   6.05   4.57NA   4.98NA   4.57     4.98     1.28  11.90  12.31  11.90  12.31  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49572  Rpr epigastric hern blocked                       A   7.87   5.24NA   5.78NA   5.24     5.78     1.64  14.75  15.29  14.75  15.29  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49580  Rpr umbil hern reduc < 5 yr                       A   4.47   3.99NA   4.39NA   3.99     4.39     0.95   9.41   9.81   9.41   9.81  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49582  Rpr umbil hern block < 5 yr                       A   7.13   5.13NA   5.64NA   5.13     5.64     1.52  13.78  14.29  13.78  14.29  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49585  Rpr umbil hern reduc > 5 yr                       A   6.59   4.77NA   5.20NA   4.77     5.20     1.37  12.73  13.16  12.73  13.16  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49587  Rpr umbil hern block > 5 yr                       A   8.04   5.33NA   5.83NA   5.33     5.83     1.68  15.05  15.55  15.05  15.55  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49590  Repair spigelian hernia                           A   8.90   5.70NA   6.24NA   5.70     6.24     1.87  16.47  17.01  16.47  17.01  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49600  Repair umbilical lesion                           A  11.55   7.18NA   7.71NA   7.18     7.71     2.44  21.17  21.70  21.17  21.70  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49605  Repair umbilical lesion                           A  87.09  39.18NA  42.20NA  39.18    42.20    18.54 144.81 147.83 144.81 147.83  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49606  Repair umbilical lesion                           A  19.00   9.80NA  10.75NA   9.80    10.75     4.05  32.85  33.80  32.85  33.80  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49610  Repair umbilical lesion                           A  10.91   6.66NA   7.21NA   6.66     7.21     2.31  19.88  20.43  19.88  20.43  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49611  Repair umbilical lesion                           A   9.34   6.15NA   6.03NA   6.15     6.03     0.65  16.14  16.02  16.14  16.02  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49650  Lap ing hernia repair init                        A   6.36   4.58NA   4.99NA   4.58     4.99     1.33  12.27  12.68  12.27  12.68  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49651  Lap ing hernia repair recur                       A   8.38   5.81NA   6.38NA   5.81     6.38     1.78  15.97  16.54  15.97  16.54  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49652  Lap vent/abd hernia repair                        A  12.88   7.42NA   8.14NA   7.42     8.14     0.90  21.20  21.92  21.20  21.92  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49653  Lap vent/abd hern proc comp                       A  16.21   9.20NA  10.12NA   9.20    10.12     1.15  26.56  27.48  26.56  27.48  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49654  Lap inc hernia repair                             A  15.03   8.27NA   9.11NA   8.27     9.11     1.06  24.36  25.20  24.36  25.20  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49655  Lap inc hern repair comp                          A  18.11   9.93NA  10.93NA   9.93    10.93     1.28  29.32  30.32  29.32  30.32  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49656  Lap inc hernia repair recur                       A  15.08   8.30NA   9.15NA   8.30     9.15     1.07  24.45  25.30  24.45  25.30  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49657  Lap inc hern recur comp                           A  22.11  11.48NA  12.70NA  11.48    12.70     1.56  35.15  36.37  35.15  36.37  0090.09.81.1021210             25.5217 090 99      0.00   0.00   0.00
49659  Laparo proc hernia repair                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
49900  Repair of abdominal wall                          A  12.41   8.60NA   9.30NA   8.60     9.30     2.54  23.55  24.25  23.55  24.25  0090.09.81.1020210             25.5217 090 99      0.00   0.00   0.00
49904  Omental flap extra-abdom                          A  22.35  15.84NA  15.87NA  15.84    15.87     4.74  42.93  42.96  42.93  42.96  0090.10.80.1020111             25.5217 090 99      0.00   0.00   0.00
49905  Omental flap intra-abdom                          A   6.54   2.60NA   2.81NA   2.60     2.81     1.24  10.38  10.59  10.38  10.59  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
49906  Free omental flap microvasc                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.09.81.1020110             25.5217 090 99      0.00   0.00   0.00
49999  Abdomen surgery procedure                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020111             25.5217 090 99      0.00   0.00   0.00
50010  Exploration of kidney                             A  12.28   7.94NA   7.79NA   7.94     7.79     1.79  22.01  21.86  22.01  21.86  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50020  Renal abscess open drain                          A  18.08  10.81NA  10.81NA  10.81    10.81     2.40  31.29  31.29  31.29  31.29  0090.08.83.0920110             25.5217 090 99      0.00   0.00   0.00
50021  Renal abscess percut drain                        A   3.37  24.30    22.57     1.40     1.23     0.31  27.98  26.25   5.08   4.91  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
50040  Drainage of kidney                                A  16.68   9.81NA   8.81NA   9.81     8.81     1.68  28.17  27.17  28.17  27.17  0090.08.83.0920110             25.5217 090 99      0.00   0.00   0.00
50045  Exploration of kidney                             A  16.82   9.83NA   8.93NA   9.83     8.93     1.62  28.27  27.37  28.27  27.37  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
5005F  Pt counsld on exam for moles                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
50060  Removal of kidney stone                           A  20.95  11.78NA  10.55NA  11.78    10.55     2.01  34.74  33.51  34.74  33.51  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50065  Incision of kidney                                A  22.32  12.12NA  11.09NA  12.12    11.09     2.16  36.60  35.57  36.60  35.57  0090.08.83.0920200             25.5217 090 99      0.00   0.00   0.00
50070  Incision of kidney                                A  21.85  12.26NA  10.91NA  12.26    10.91     2.12  36.23  34.88  36.23  34.88  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50075  Removal of kidney stone                           A  27.09  14.80NA  13.19NA  14.80    13.19     2.62  44.51  42.90  44.51  42.90  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50080  Removal of kidney stone                           A  15.74   9.27NA   8.27NA   9.27     8.27     1.55  26.56  25.56  26.56  25.56  0090.08.83.0921100             25.5217 090 99      0.00   0.00   0.00
50081  Removal of kidney stone                           A  23.50  13.19NA  11.79NA  13.19    11.79     2.31  39.00  37.60  39.00  37.60  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
5010F  Macul result to phy mng dm                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
50100  Revise kidney blood vessels                       A  17.45   8.35NA   7.25NA   8.35     7.25     3.72  29.52  28.42  29.52  28.42  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50120  Exploration of kidney                             A  17.21   9.95NA   9.01NA   9.95     9.01     1.66  28.82  27.88  28.82  27.88  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50125  Explore and drain kidney                          A  17.82  11.11NA  11.11NA  11.11    11.11     1.71  30.64  30.64  30.64  30.64  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50130  Removal of kidney stone                           A  18.82  10.89NA   9.76NA  10.89     9.76     1.82  31.53  30.40  31.53  30.40  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50135  Exploration of kidney                             A  20.59  11.56NA  10.41NA  11.56    10.41     1.98  34.13  32.98  34.13  32.98  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
5015F  Doc fx & test/txmnt for op                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
5020F  Txmnts 2 main Dr by 1 mon                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
50200  Renal biopsy perq                                 A   2.63  14.16    14.16     1.42     1.29     0.31  17.10  17.10   4.36   4.23  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50205  Renal biopsy open                                 A  12.29   7.23NA   7.64NA   7.23     7.64     2.39  21.91  22.32  21.91  22.32  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50220  Remove kidney open                                A  18.68  10.70NA   9.89NA  10.70     9.89     2.24  31.62  30.81  31.62  30.81  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50225  Removal kidney open complex                       A  21.88  12.06NA  11.07NA  12.06    11.07     2.38  36.32  35.33  36.32  35.33  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50230  Removal kidney open radical                       A  23.81  12.79NA  11.52NA  12.79    11.52     2.44  39.04  37.77  39.04  37.77  0090.08.83.0921220             25.5217 090 99      0.00   0.00   0.00
50234  Removal of kidney & ureter                        A  24.05  13.16NA  11.88NA  13.16    11.88     2.43  39.64  38.36  39.64  38.36  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50236  Removal of kidney & ureter                        A  26.94  15.15NA  13.55NA  15.15    13.55     2.63  44.72  43.12  44.72  43.12  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50240  Partial removal of kidney                         A  24.21  13.72NA  12.35NA  13.72    12.35     2.42  40.35  38.98  40.35  38.98  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50250  Cryoablate renal mass open                        A  22.22  12.86NA  11.40NA  12.86    11.40     2.17  37.25  35.79  37.25  35.79  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50280  Removal of kidney lesion                          A  17.09  10.08NA   9.24NA  10.08     9.24     1.86  29.03  28.19  29.03  28.19  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50290  Removal of kidney lesion                          A  16.15   9.89NA  10.38NA   9.89    10.38     1.56  27.60  28.09  27.60  28.09  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50300  Remove cadaver donor kidney                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
50320  Remove kidney living donor                        A  22.43  15.40NA  15.49NA  15.40    15.49     3.87  41.70  41.79  41.70  41.79  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50323  Prep cadaver renal allograft                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
50325  Prep donor renal graft                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
50327  Prep renal graft/venous                           A   4.00   1.61NA   1.70NA   1.61     1.70     0.77   6.38   6.47   6.38   6.47  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
50328  Prep renal graft/arterial                         A   3.50   1.41NA   1.48NA   1.41     1.48     0.67   5.58   5.65   5.58   5.65  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
50329  Prep renal graft/ureteral                         A   3.34   1.42NA   1.37NA   1.42     1.37     0.48   5.24   5.19   5.24   5.19  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
50340  Removal of kidney                                 A  14.04  10.10NA  11.05NA  10.10    11.05     3.00  27.14  28.09  27.14  28.09  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50360  Transplantation of kidney                         A  40.90  24.92NA  27.22NA  24.92    27.22     8.28  74.10  76.40  74.10  76.40  0090.08.83.0920222             25.5217 090 99      0.00   0.00   0.00
50365  Transplantation of kidney                         A  46.13  27.52NA  29.82NA  27.52    29.82     9.82  83.47  85.77  83.47  85.77  0090.08.83.0921222             25.5217 090 99      0.00   0.00   0.00
50370  Remove transplanted kidney                        A  18.88  11.98NA  13.01NA  11.98    13.01     3.75  34.61  35.64  34.61  35.64  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50380  Reimplantation of kidney                          A  30.11  22.02NA  22.85NA  22.02    22.85     6.40  58.53  59.36  58.53  59.36  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50382  Change ureter stent percut                        A   5.50  31.83    28.06     2.38     2.07     0.52  37.85  34.08   8.40   8.09  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50384  Remove ureter stent percut                        A   5.00  26.14    22.03     2.15     1.86     0.48  31.62  27.51   7.63   7.34  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50385  Change stent via transureth                       A   4.44  32.12    28.19     2.31     1.98     0.42  36.98  33.05   7.17   6.84  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
50386  Remove stent via transureth                       A   3.30  20.49    18.15     1.81     1.56     0.31  24.10  21.76   5.42   5.17  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
50387  Change ext/int ureter stent                       A   2.00  15.35    13.51     0.85     0.73     0.20  17.55  15.71   3.05   2.93  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
50389  Remove renal tube w/fluoro                        A   1.10   8.56     7.09     0.47     0.41     0.10   9.76   8.29   1.67   1.61  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50390  Drainage of kidney lesion                         A   1.96   0.82NA   0.72NA   0.82     0.72     0.18   2.96   2.86   2.96   2.86  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50391  Instll rx agnt into rnal tub                      A   1.96   1.66     1.43     0.88     0.79     0.20   3.82   3.59   3.04   2.95  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
50392  Insert kidney drain                               A   3.37   1.77NA   1.56NA   1.77     1.56     0.31   5.45   5.24   5.45   5.24  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50393  Insert ureteral tube                              A   4.15   2.10NA   1.84NA   2.10     1.84     0.38   6.63   6.37   6.63   6.37  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50394  Injection for kidney x-ray                        A   0.76   2.27     1.99     0.68     0.61     0.07   3.10   2.82   1.51   1.44  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50395  Create passage to kidney                          A   3.37   1.80NA   1.59NA   1.80     1.59     0.33   5.50   5.29   5.50   5.29  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50396  Measure kidney pressure                           A   2.09   1.26NA   1.10NA   1.26     1.10     0.20   3.55   3.39   3.55   3.39  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
50398  Change kidney tube                                A   1.46  14.30    12.74     0.65     0.57     0.12  15.88  14.32   2.23   2.15  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50400  Revision of kidney/ureter                         A  21.27  11.86NA  10.73NA  11.86    10.73     2.09  35.22  34.09  35.22  34.09  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50405  Revision of kidney/ureter                         A  25.86  14.14NA  12.71NA  14.14    12.71     2.50  42.50  41.07  42.50  41.07  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
5050F  Plan 2 main dr by 1 month                         M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
50500  Repair of kidney wound                            A  21.22  11.66NA  12.04NA  11.66    12.04     4.51  37.39  37.77  37.39  37.77  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50520  Close kidney-skin fistula                         A  18.88  10.72NA   9.74NA  10.72     9.74     1.83  31.43  30.45  31.43  30.45  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50525  Repair renal-abdomen fistula                      A  24.39  13.94NA  14.20NA  13.94    14.20     5.19  43.52  43.78  43.52  43.78  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50526  Repair renal-abdomen fistula                      A  26.31  13.77NA  14.24NA  13.77    14.24     1.86  41.94  42.41  41.94  42.41  0090.08.83.0920200             25.5217 090 99      0.00   0.00   0.00
50540  Revision of horseshoe kidney                      A  21.10  11.50NA  10.61NA  11.50    10.61     2.02  34.62  33.73  34.62  33.73  0090.08.83.0922210             25.5217 090 99      0.00   0.00   0.00
50541  Laparo ablate renal cyst                          A  16.86   9.51NA   8.56NA   9.51     8.56     1.70  28.07  27.12  28.07  27.12  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50542  Laparo ablate renal mass                          A  21.36  12.17NA  10.92NA  12.17    10.92     2.09  35.62  34.37  35.62  34.37  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50543  Laparo partial nephrectomy                        A  27.41  15.32NA  13.74NA  15.32    13.74     2.72  45.45  43.87  45.45  43.87  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50544  Laparoscopy pyeloplasty                           A  23.37  12.42NA  11.10NA  12.42    11.10     2.31  38.10  36.78  38.10  36.78  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50545  Laparo radical nephrectomy                        A  25.06  13.40NA  12.00NA  13.40    12.00     2.54  41.00  39.60  41.00  39.60  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50546  Laparoscopic nephrectomy                          A  21.87  12.42NA  11.24NA  12.42    11.24     2.30  36.59  35.41  36.59  35.41  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50547  Laparo removal donor kidney                       A  26.34  15.91NA  16.40NA  15.91    16.40     4.82  47.07  47.56  47.07  47.56  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50548  Laparo remove w/ureter                            A  25.36  13.34NA  11.91NA  13.34    11.91     2.50  41.20  39.77  41.20  39.77  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50549  Laparoscope proc renal                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
50551  Kidney endoscopy                                  A   5.59   4.95     4.28     2.89     2.58     0.54  11.08  10.41   9.02   8.71  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
50553  Kidney endoscopy                                  A   5.98   5.14     4.56     3.01     2.69     0.65  11.77  11.19   9.64   9.32  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50555  Kidney endoscopy & biopsy                         A   6.52   5.50     4.79     3.30     2.94     0.62  12.64  11.93  10.44  10.08  0000.00.00.0031000       50551 25.5217 090 99      0.00   0.00   0.00
50557  Kidney endoscopy & treatment                      A   6.61   5.63     4.88     3.34     2.97     0.64  12.88  12.13  10.59  10.22  0000.00.00.0031000       50551 25.5217 090 99      0.00   0.00   0.00
50561  Kidney endoscopy & treatment                      A   7.58   6.30     5.48     3.78     3.36     0.75  14.63  13.81  12.11  11.69  0000.00.00.0031000       50551 25.5217 090 99      0.00   0.00   0.00
50562  Renal scope w/tumor resect                        A  10.90   5.87NA   5.18NA   5.87     5.18     1.06  17.83  17.14  17.83  17.14  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50570  Kidney endoscopy                                  A   9.53   4.62NA   4.09NA   4.62     4.09     0.91  15.06  14.53  15.06  14.53  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
50572  Kidney endoscopy                                  A  10.33   4.99NA   4.40NA   4.99     4.40     1.00  16.32  15.73  16.32  15.73  0000.00.00.0031000       50570 25.5217 090 99      0.00   0.00   0.00
50574  Kidney endoscopy & biopsy                         A  11.00   5.27NA   4.67NA   5.27     4.67     1.07  17.34  16.74  17.34  16.74  0000.00.00.0031000       50570 25.5217 090 99      0.00   0.00   0.00
50575  Kidney endoscopy                                  A  13.96   6.60NA   5.83NA   6.60     5.83     1.36  21.92  21.15  21.92  21.15  0000.00.00.0031100       50570 25.5217 090 99      0.00   0.00   0.00
50576  Kidney endoscopy & treatment                      A  10.97   5.27NA   4.66NA   5.27     4.66     1.06  17.30  16.69  17.30  16.69  0000.00.00.0031000       50570 25.5217 090 99      0.00   0.00   0.00
50580  Kidney endoscopy & treatment                      A  11.84   5.59NA   5.00NA   5.59     5.00     1.15  18.58  17.99  18.58  17.99  0000.00.00.0031000       50570 25.5217 090 99      0.00   0.00   0.00
50590  Fragmenting of kidney stone                       A   9.77  15.39    11.28     6.50     5.83     0.95  26.11  22.00  17.22  16.55  0090.08.83.0921100             25.5217 090 99      0.00   0.00   0.00
50592  Perc rf ablate renal tumor                        A   6.80  94.45    76.66     3.57     3.17     0.64 101.89  84.10  11.01  10.61  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
50593  Perc cryo ablate renal tum                        A   9.13 130.21   115.70     4.32     4.23     0.86 140.20 125.69  14.31  14.22  0010.10.80.1021200             25.5217 090 99      0.00   0.00   0.00
5060F  Fndngs mammo 2pt w/in 3 days                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
50600  Exploration of ureter                             A  17.17   9.69NA   8.77NA   9.69     8.77     1.66  28.52  27.60  28.52  27.60  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50605  Insert ureteral support                           A  16.79   9.53NA   9.42NA   9.53     9.42     2.65  28.97  28.86  28.97  28.86  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50610  Removal of ureter stone                           A  17.25   9.90NA   8.87NA   9.90     8.87     1.66  28.81  27.78  28.81  27.78  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
5062F  Mammo result com to pt 5 day                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
50620  Removal of ureter stone                           A  16.43   9.54NA   8.55NA   9.54     8.55     1.59  27.56  26.57  27.56  26.57  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50630  Removal of ureter stone                           A  16.21   9.23NA   8.46NA   9.23     8.46     1.56  27.00  26.23  27.00  26.23  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50650  Removal of ureter                                 A  18.82  10.83NA   9.78NA  10.83     9.78     1.89  31.54  30.49  31.54  30.49  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50660  Removal of ureter                                 A  21.02  11.71NA  10.58NA  11.71    10.58     2.02  34.75  33.62  34.75  33.62  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50684  Injection for ureter x-ray                        A   0.76   3.63     2.15     0.68     0.62     0.07   4.46   2.98   1.51   1.45  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
50686  Measure ureter pressure                           A   1.51   2.63     2.63     1.12     1.03     0.22   4.36   4.36   2.85   2.76  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
50688  Change of ureter tube/stent                       A   1.20   1.12NA   0.99NA   1.12     0.99     0.11   2.43   2.30   2.43   2.30  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
50690  Injection for ureter x-ray                        A   1.16   1.71     1.48     0.85     0.76     0.10   2.97   2.74   2.11   2.02  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
50700  Revision of ureter                                A  16.69   9.81NA   8.88NA   9.81     8.88     1.62  28.12  27.19  28.12  27.19  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50715  Release of ureter                                 A  20.64  11.32NA  11.64NA  11.32    11.64     3.00  34.96  35.28  34.96  35.28  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50722  Release of ureter                                 A  17.95  10.06NA  10.55NA  10.06    10.55     3.04  31.05  31.54  31.05  31.54  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50725  Release/revise ureter                             A  20.20  12.01NA  12.15NA  12.01    12.15     1.94  34.15  34.29  34.15  34.29  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50727  Revise ureter                                     A   8.28   6.24NA   5.68NA   6.24     5.68     0.84  15.36  14.80  15.36  14.80  0090.08.83.0920220             25.5217 090 99      0.00   0.00   0.00
50728  Revise ureter                                     A  12.18   7.70NA   7.10NA   7.70     7.10     1.18  21.06  20.46  21.06  20.46  0090.08.83.0920220             25.5217 090 99      0.00   0.00   0.00
50740  Fusion of ureter & kidney                         A  20.07  11.25NA  11.45NA  11.25    11.45     4.28  35.60  35.80  35.60  35.80  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50750  Fusion of ureter & kidney                         A  21.22  11.98NA  10.66NA  11.98    10.66     2.04  35.24  33.92  35.24  33.92  0090.08.83.0920200             25.5217 090 99      0.00   0.00   0.00
50760  Fusion of ureters                                 A  20.07  11.24NA  10.62NA  11.24    10.62     2.66  33.97  33.35  33.97  33.35  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50770  Splicing of ureters                               A  21.22  11.30NA  10.66NA  11.30    10.66     2.04  34.56  33.92  34.56  33.92  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50780  Reimplant ureter in bladder                       A  19.95  11.26NA  10.38NA  11.26    10.38     2.31  33.52  32.64  33.52  32.64  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50782  Reimplant ureter in bladder                       A  19.66  10.89NA  10.04NA  10.89    10.04     4.18  34.73  33.88  34.73  33.88  0090.08.83.0921220             25.5217 090 99      0.00   0.00   0.00
50783  Reimplant ureter in bladder                       A  20.70  11.98NA  12.37NA  11.98    12.37     2.00  34.68  35.07  34.68  35.07  0090.08.83.0921220             25.5217 090 99      0.00   0.00   0.00
50785  Reimplant ureter in bladder                       A  22.23  12.37NA  11.20NA  12.37    11.20     2.24  36.84  35.67  36.84  35.67  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50800  Implant ureter in bowel                           A  16.41  10.00NA   9.12NA  10.00     9.12     1.74  28.15  27.27  28.15  27.27  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50810  Fusion of ureter & bowel                          A  22.61  12.15NA  11.88NA  12.15    11.88     4.82  39.58  39.31  39.58  39.31  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50815  Urine shunt to intestine                          A  22.26  12.77NA  11.52NA  12.77    11.52     2.16  37.19  35.94  37.19  35.94  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50820  Construct bowel bladder                           A  24.07  13.24NA  12.25NA  13.24    12.25     2.65  39.96  38.97  39.96  38.97  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50825  Construct bowel bladder                           A  30.68  16.59NA  15.05NA  16.59    15.05     3.16  50.43  48.89  50.43  48.89  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50830  Revise urine flow                                 A  33.77  17.51NA  16.05NA  17.51    16.05     3.29  54.57  53.11  54.57  53.11  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50840  Replace ureter by bowel                           A  22.39  12.88NA  11.57NA  12.88    11.57     2.17  37.44  36.13  37.44  36.13  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50845  Appendico-vesicostomy                             A  22.46  13.38NA  12.04NA  13.38    12.04     2.17  38.01  36.67  38.01  36.67  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50860  Transplant ureter to skin                         A  17.08   9.98NA   9.03NA   9.98     9.03     1.64  28.70  27.75  28.70  27.75  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50900  Repair of ureter                                  A  15.04   9.08NA   8.52NA   9.08     8.52     1.47  25.59  25.03  25.59  25.03  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50920  Closure ureter/skin fistula                       A  15.81   9.48NA   8.53NA   9.48     8.53     1.53  26.82  25.87  26.82  25.87  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50930  Closure ureter/bowel fistula                      A  20.19  10.75NA  10.25NA  10.75    10.25     4.29  35.23  34.73  35.23  34.73  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
50940  Release of ureter                                 A  15.93   9.42NA   8.58NA   9.42     8.58     1.55  26.90  26.06  26.90  26.06  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50945  Laparoscopy ureterolithotomy                      A  17.97   9.95NA   8.93NA   9.95     8.93     1.74  29.66  28.64  29.66  28.64  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50947  Laparo new ureter/bladder                         A  25.78  13.73NA  12.45NA  13.73    12.45     2.50  42.01  40.73  42.01  40.73  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50948  Laparo new ureter/bladder                         A  23.82  12.86NA  11.43NA  12.86    11.43     2.30  38.98  37.55  38.98  37.55  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
50949  Laparoscope proc ureter                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021210             25.5217 090 99      0.00   0.00   0.00
50951  Endoscopy of ureter                               A   5.83   5.18     4.48     3.02     2.68     0.56  11.57  10.87   9.41   9.07  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
50953  Endoscopy of ureter                               A   6.23   5.41     4.69     3.55     3.16     0.61  12.25  11.53  10.39  10.00  0000.00.00.0031000       50951 25.5217 090 99      0.00   0.00   0.00
50955  Ureter endoscopy & biopsy                         A   6.74   5.94     4.94     3.81     3.37     0.65  13.33  12.33  11.20  10.76  0000.00.00.0031000       50951 25.5217 090 99      0.00   0.00   0.00
50957  Ureter endoscopy & treatment                      A   6.78   5.73     4.99     3.42     3.04     0.65  13.16  12.42  10.85  10.47  0000.00.00.0031000       50951 25.5217 090 99      0.00   0.00   0.00
50961  Ureter endoscopy & treatment                      A   6.04   5.26     4.56     3.10     2.75     0.58  11.88  11.18   9.72   9.37  0000.00.00.0031000       50951 25.5217 090 99      0.00   0.00   0.00
50970  Ureter endoscopy                                  A   7.13   3.55NA   3.14NA   3.55     3.14     0.68  11.36  10.95  11.36  10.95  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
50972  Ureter endoscopy & catheter                       A   6.88   3.42NA   3.05NA   3.42     3.05     0.67  10.97  10.60  10.97  10.60  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
50974  Ureter endoscopy & biopsy                         A   9.16   4.46NA   3.94NA   4.46     3.94     0.88  14.50  13.98  14.50  13.98  0000.00.00.0031000       50970 25.5217 090 99      0.00   0.00   0.00
50976  Ureter endoscopy & treatment                      A   9.03   4.38NA   3.89NA   4.38     3.89     0.87  14.28  13.79  14.28  13.79  0000.00.00.0031000       50970 25.5217 090 99      0.00   0.00   0.00
50980  Ureter endoscopy & treatment                      A   6.84   3.43NA   3.03NA   3.43     3.03     0.65  10.92  10.52  10.92  10.52  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
5100F  Rsk fx ref w/n 24 hrs xray                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
51020  Incise & treat bladder                            A   7.69   5.81NA   5.22NA   5.81     5.22     0.77  14.27  13.68  14.27  13.68  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51030  Incise & treat bladder                            A   7.81   5.59NA   5.17NA   5.59     5.17     0.75  14.15  13.73  14.15  13.73  0090.08.83.0920000             25.5217 090 99      0.00   0.00   0.00
51040  Incise & drain bladder                            A   4.49   3.92NA   3.48NA   3.92     3.48     0.43   8.84   8.40   8.84   8.40  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51045  Incise bladder/drain ureter                       A   7.81   5.88NA   5.59NA   5.88     5.59     1.06  14.75  14.46  14.75  14.46  0090.08.83.0920200             25.5217 090 99      0.00   0.00   0.00
51050  Removal of bladder stone                          A   7.97   5.65NA   5.07NA   5.65     5.07     0.77  14.39  13.81  14.39  13.81  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51060  Removal of ureter stone                           A   9.95   6.80NA   6.08NA   6.80     6.08     0.98  17.73  17.01  17.73  17.01  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51065  Remove ureter calculus                            A   9.95   6.68NA   6.00NA   6.68     6.00     0.98  17.61  16.93  17.61  16.93  0090.08.83.0920000             25.5217 090 99      0.00   0.00   0.00
51080  Drainage of bladder abscess                       A   6.71   5.03NA   4.56NA   5.03     4.56     0.65  12.39  11.92  12.39  11.92  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51100  Drain bladder by needle                           A   0.78   1.02     0.95     0.33     0.31     0.08   1.88   1.81   1.19   1.17  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51101  Drain bladder by trocar/cath                      A   1.02   2.71     2.46     0.46     0.45     0.12   3.85   3.60   1.60   1.59  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51102  Drain bl w/cath insertion                         A   2.70   4.03     3.51     1.50     1.31     0.29   7.02   6.50   4.49   4.30  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51500  Removal of bladder cyst                           A  11.05   7.59NA   7.95NA   7.59     7.95     1.07  19.71  20.07  19.71  20.07  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51520  Removal of bladder lesion                         A  10.21   6.73NA   6.19NA   6.73     6.19     0.99  17.93  17.39  17.93  17.39  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51525  Removal of bladder lesion                         A  15.42   9.21NA   8.28NA   9.21     8.28     1.56  26.19  25.26  26.19  25.26  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51530  Removal of bladder lesion                         A  13.71   8.49NA   8.01NA   8.49     8.01     1.64  23.84  23.36  23.84  23.36  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51535  Repair of ureter lesion                           A  13.90   8.31NA   7.62NA   8.31     7.62     1.33  23.54  22.85  23.54  22.85  0090.08.83.0921210             25.5217 090 99      0.00   0.00   0.00
51550  Partial removal of bladder                        A  17.23   9.92NA   9.23NA   9.92     9.23     2.13  29.28  28.59  29.28  28.59  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51555  Partial removal of bladder                        A  23.18  12.77NA  11.75NA  12.77    11.75     2.59  38.54  37.52  38.54  37.52  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51565  Revise bladder & ureter(s)                        A  23.68  13.19NA  12.12NA  13.19    12.12     2.42  39.29  38.22  39.29  38.22  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51570  Removal of bladder                                A  27.46  14.67NA  13.55NA  14.67    13.55     2.80  44.93  43.81  44.93  43.81  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51575  Removal of bladder & nodes                        A  34.18  18.04NA  16.17NA  18.04    16.17     3.34  55.56  53.69  55.56  53.69  0090.08.83.0922210             25.5217 090 99      0.00   0.00   0.00
51580  Remove bladder/revise tract                       A  35.37  19.07NA  17.03NA  19.07    17.03     3.44  57.88  55.84  57.88  55.84  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51585  Removal of bladder & nodes                        A  39.64  20.95NA  18.71NA  20.95    18.71     3.84  64.43  62.19  64.43  62.19  0090.08.83.0922210             25.5217 090 99      0.00   0.00   0.00
51590  Remove bladder/revise tract                       A  36.33  18.92NA  17.03NA  18.92    17.03     3.67  58.92  57.03  58.92  57.03  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51595  Remove bladder/revise tract                       A  41.32  21.40NA  19.20NA  21.40    19.20     4.10  66.82  64.62  66.82  64.62  0090.08.83.0922210             25.5217 090 99      0.00   0.00   0.00
51596  Remove bladder/create pouch                       A  44.26  23.20NA  20.79NA  23.20    20.79     4.33  71.79  69.38  71.79  69.38  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51597  Removal of pelvic structures                      A  42.86  22.42NA  20.45NA  22.42    20.45     4.52  69.80  67.83  69.80  67.83  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51600  Injection for bladder x-ray                       A   0.88   4.83     4.23     0.38     0.34     0.08   5.79   5.19   1.34   1.30  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51605  Preparation for bladder xray                      A   0.64   0.47NA   0.42NA   0.47     0.42     0.05   1.16   1.11   1.16   1.11  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51610  Injection for bladder x-ray                       A   1.05   2.17     1.88     0.78     0.71     0.10   3.32   3.03   1.93   1.86  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51700  Irrigation of bladder                             A   0.88   1.63     1.40     0.39     0.36     0.08   2.59   2.36   1.35   1.32  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51701  Insert bladder catheter                           A   0.50   1.21     1.00     0.28     0.26     0.05   1.76   1.55   0.83   0.81  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51702  Insert temp bladder cath                          A   0.50   1.73     1.43     0.36     0.33     0.05   2.28   1.98   0.91   0.88  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51703  Insert bladder cath complex                       A   1.47   2.51     2.08     0.87     0.79     0.14   4.12   3.69   2.48   2.40  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51705  Change of bladder tube                            A   1.05   2.20     1.85     0.90     0.81     0.10   3.35   3.00   2.05   1.96  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
51710  Change of bladder tube                            A   1.52   3.01     2.48     1.24     1.11     0.14   4.67   4.14   2.90   2.77  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
51715  Endoscopic injection/implant                      A   3.73   4.74     4.18     1.95     1.80     0.39   8.86   8.30   6.07   5.92  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51720  Treatment of bladder lesion                       A   1.50   1.77     1.49     0.83     0.72     0.14   3.41   3.13   2.47   2.36  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51725  Simple cystometrogram                             A   1.51   4.59     3.64     4.59NA   3.64 NA  0.13   6.23   5.28   6.23   5.28  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51725TCSimple cystometrogram                             A   0.00   3.93     3.01     3.93NA   3.01 NA  0.01   3.94   3.02   3.94   3.02  1000.00.00.0020000             25.5217 020 99      0.00   0.00   0.00
5172526Simple cystometrogram                             A   1.51   0.66     0.63     0.66     0.63     0.12   2.29   2.26   2.29   2.26  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51726  Complex cystometrogram                            A   1.71   7.22     5.72     7.22NA   5.72 NA  0.17   9.10   7.60   9.10   7.60  1000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51726TCComplex cystometrogram                            A   0.00   6.46     5.01     6.46NA   5.01 NA  0.03   6.49   5.04   6.49   5.04  1000.00.00.0020100             25.5217 020 99      0.00   0.00   0.00
5172626Complex cystometrogram                            A   1.71   0.76     0.71     0.76     0.71     0.14   2.61   2.56   2.61   2.56  1000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51727  Cystometrogram w/up                               A   2.11   6.71     6.71     6.71NA   6.71 NA  0.23   9.05   9.05   9.05   9.05  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51727TCCystometrogram w/up                               A   0.00   5.81     5.81     5.81NA   5.81 NA  0.01   5.82   5.82   5.82   5.82  1000.00.00.0020000             25.5217 020 99      0.00   0.00   0.00
5172726Cystometrogram w/up                               A   2.11   0.90     0.90     0.90     0.90     0.22   3.23   3.23   3.23   3.23  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51728  Cystometrogram w/vp                               A   2.11   6.66     6.66     6.66NA   6.66 NA  0.19   8.96   8.96   8.96   8.96  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51728TCCystometrogram w/vp                               A   0.00   5.79     5.79     5.79NA   5.79 NA  0.01   5.80   5.80   5.80   5.80  1000.00.00.0020000             25.5217 020 99      0.00   0.00   0.00
5172826Cystometrogram w/vp                               A   2.11   0.87     0.87     0.87     0.87     0.18   3.16   3.16   3.16   3.16  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51729  Cystometrogram w/vp&up                            A   2.51   7.06     7.06     7.06NA   7.06 NA  0.25   9.82   9.82   9.82   9.82  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51729TCCystometrogram w/vp&up                            A   0.00   5.99     5.99     5.99NA   5.99 NA  0.01   6.00   6.00   6.00   6.00  1000.00.00.0020000             25.5217 020 99      0.00   0.00   0.00
5172926Cystometrogram w/vp&up                            A   2.51   1.07     1.07     1.07     1.07     0.24   3.82   3.82   3.82   3.82  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51736  Urine flow measurement                            A   0.17   0.85     0.66     0.85NA   0.66 NA  0.02   1.04   0.85   1.04   0.85  1XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51736TCUrine flow measurement                            A   0.00   0.67     0.59     0.67NA   0.59 NA  0.01   0.68   0.60   0.68   0.60  1XXX.00.00.0020000             25.5217 020 99      0.00   0.00   0.00
5173626Urine flow measurement                            A   0.17   0.18     0.07     0.18     0.07     0.01   0.36   0.25   0.36   0.25  1XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51741  Electro-uroflowmetry first                        A   0.17   1.09     0.76     1.09NA   0.76 NA  0.02   1.28   0.95   1.28   0.95  1XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51741TCElectro-uroflowmetry first                        A   0.00   0.78     0.69     0.78NA   0.69 NA  0.01   0.79   0.70   0.79   0.70  1XXX.00.00.0020100             25.5217 020 99      0.00   0.00   0.00
5174126Electro-uroflowmetry first                        A   0.17   0.31     0.07     0.31     0.07     0.01   0.49   0.25   0.49   0.25  1XXX.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51784  Anal/urinary muscle study                         A   1.53   4.42     3.92     4.42NA   3.92 NA  0.13   6.08   5.58   6.08   5.58  1000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51784TCAnal/urinary muscle study                         A   0.00   3.75     3.28     3.75NA   3.28 NA  0.01   3.76   3.29   3.76   3.29  1000.00.00.0020100             25.5217 020 99      0.00   0.00   0.00
5178426Anal/urinary muscle study                         A   1.53   0.67     0.64     0.67     0.64     0.12   2.32   2.29   2.32   2.29  1000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
51785  Anal/urinary muscle study                         A   1.53   5.02     4.52     5.02NA   4.52 NA  0.13   6.68   6.18   6.68   6.18  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51785TCAnal/urinary muscle study                         A   0.00   4.34     3.87     4.34NA   3.87 NA  0.01   4.35   3.88   4.35   3.88  1000.00.00.0020000             25.5217 030 99      0.00   0.00   0.00
5178526Anal/urinary muscle study                         A   1.53   0.68     0.65     0.68     0.65     0.12   2.33   2.30   2.33   2.30  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51792  Urinary reflex study                              A   1.10   5.68     4.99     5.68NA   4.99 NA  0.11   6.89   6.20   6.89   6.20  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51792TCUrinary reflex study                              A   0.00   5.18     4.51     5.18NA   4.51 NA  0.01   5.19   4.52   5.19   4.52  1000.00.00.0020000             25.5217 020 99      0.00   0.00   0.00
5179226Urinary reflex study                              A   1.10   0.50     0.48     0.50     0.48     0.10   1.70   1.68   1.70   1.68  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
51797  Intraabdominal pressure test                      A   0.80   3.13     2.28     3.13NA   2.28 NA  0.06   3.99   3.14   3.99   3.14  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
51797TCIntraabdominal pressure test                      A   0.00   2.74     1.95     2.74NA   1.95 NA  0.01   2.75   1.96   2.75   1.96  1ZZZ.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
5179726Intraabdominal pressure test                      A   0.80   0.39     0.33     0.39     0.33     0.05   1.24   1.18   1.24   1.18  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
51798  Us urine capacity measure                         A   0.00   0.57     0.51     0.57NA   0.51 NA  0.01   0.58   0.52   0.58   0.52  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
51800  Revision of bladder/urethra                       A  18.89  10.99NA   9.95NA  10.99     9.95     1.94  31.82  30.78  31.82  30.78  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51820  Revision of urinary tract                         A  19.59  10.94NA  10.33NA  10.94    10.33     1.89  32.42  31.81  32.42  31.81  0090.08.83.0922210             25.5217 090 99      0.00   0.00   0.00
51840  Attach bladder/urethra                            A  11.36   7.05NA   6.82NA   7.05     6.82     1.49  19.90  19.67  19.90  19.67  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51841  Attach bladder/urethra                            A  13.68   8.17NA   7.96NA   8.17     7.96     1.83  23.68  23.47  23.68  23.47  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51845  Repair bladder neck                               A  10.15   6.56NA   6.08NA   6.56     6.08     1.20  17.91  17.43  17.91  17.43  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51860  Repair of bladder wound                           A  12.60   7.97NA   7.72NA   7.97     7.72     1.85  22.42  22.17  22.42  22.17  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51865  Repair of bladder wound                           A  15.80   9.42NA   8.76NA   9.42     8.76     1.91  27.13  26.47  27.13  26.47  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51880  Repair of bladder opening                         A   7.87   5.36NA   5.00NA   5.36     5.00     0.99  14.22  13.86  14.22  13.86  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51900  Repair bladder/vagina lesion                      A  14.63   8.89NA   8.38NA   8.89     8.38     1.41  24.93  24.42  24.93  24.42  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51920  Close bladder-uterus fistula                      A  13.41   8.22NA   7.66NA   8.22     7.66     1.29  22.92  22.36  22.92  22.36  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51925  Hysterectomy/bladder repair                       A  17.53  11.34NA  11.70NA  11.34    11.70     2.96  31.83  32.19  31.83  32.19  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51940  Correction of bladder defect                      A  30.66  15.56NA  14.71NA  15.56    14.71     2.97  49.19  48.34  49.19  48.34  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51960  Revision of bladder & bowel                       A  25.40  14.32NA  12.91NA  14.32    12.91     2.65  42.37  40.96  42.37  40.96  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51980  Construct bladder opening                         A  12.57   7.87NA   7.12NA   7.87     7.12     1.22  21.66  20.91  21.66  20.91  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51990  Laparo urethral suspension                        A  13.36   7.67NA   7.48NA   7.67     7.48     1.77  22.80  22.61  22.80  22.61  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51992  Laparo sling operation                            A  14.87   8.43NA   8.55NA   8.43     8.55     2.23  25.53  25.65  25.53  25.65  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
51999  Laparoscope proc bla                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
5200F  Eval appros surg thxpy epi                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
52000  Cystoscopy                                        A   2.23   3.85     3.31     1.38     1.25     0.23   6.31   5.77   3.84   3.71  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
52001  Cystoscopy removal of clots                       A   5.44   5.52     4.71     2.82     2.52     0.53  11.49  10.68   8.79   8.49  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52005  Cystoscopy & ureter catheter                      A   2.37   6.03     5.11     1.46     1.31     0.24   8.64   7.72   4.07   3.92  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52007  Cystoscopy and biopsy                             A   3.02  12.19     9.57     1.75     1.56     0.30  15.51  12.89   5.07   4.88  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52010  Cystoscopy & duct catheter                        A   3.02   8.64     7.22     1.66     1.56     0.30  11.96  10.54   4.98   4.88  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52204  Cystoscopy w/biopsy(s)                            A   2.59   9.69     7.39     1.47     1.33     0.26  12.54  10.24   4.32   4.18  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52214  Cystoscopy and treatment                          A   3.70  14.67    13.91     2.32     1.76     0.35  18.72  17.96   6.37   5.81  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52224  Cystoscopy and treatment                          A   3.14  18.93    13.20     1.73     1.54     0.31  22.38  16.65   5.18   4.99  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52234  Cystoscopy and treatment                          A   4.62   2.47NA   2.19NA   2.47     2.19     0.43   7.52   7.24   7.52   7.24  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52235  Cystoscopy and treatment                          A   5.44   2.87NA   2.55NA   2.87     2.55     0.53   8.84   8.52   8.84   8.52  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52240  Cystoscopy and treatment                          A   9.71   4.77NA   4.23NA   4.77     4.23     0.95  15.43  14.89  15.43  14.89  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52250  Cystoscopy and radiotracer                        A   4.49   2.50NA   2.24NA   2.50     2.24     0.45   7.44   7.18   7.44   7.18  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52260  Cystoscopy and treatment                          A   3.91   2.12NA   1.91NA   2.12     1.91     0.39   6.42   6.21   6.42   6.21  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52265  Cystoscopy and treatment                          A   2.94   8.94     7.02     1.67     1.58     0.35  12.23  10.31   4.96   4.87  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52270  Cystoscopy & revise urethra                       A   3.36   8.04     6.27     1.88     1.67     0.33  11.73   9.96   5.57   5.36  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52275  Cystoscopy & revise urethra                       A   4.69  10.81     8.32     2.47     2.19     0.45  15.95  13.46   7.61   7.33  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52276  Cystoscopy and treatment                          A   4.99   2.66NA   2.36NA   2.66     2.36     0.49   8.14   7.84   8.14   7.84  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52277  Cystoscopy and treatment                          A   6.16   3.20NA   2.88NA   3.20     2.88     0.60   9.96   9.64   9.96   9.64  0000.00.00.0030000       52000 25.5217 090 99      0.00   0.00   0.00
52281  Cystoscopy and treatment                          A   2.60   5.80     4.57     1.61     1.40     0.27   8.67   7.44   4.48   4.27  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52282  Cystoscopy implant stent                          A   6.39   3.26NA   2.93NA   3.26     2.93     0.65  10.30   9.97  10.30   9.97  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52283  Cystoscopy and treatment                          A   3.73   4.43     3.85     2.06     1.87     0.37   8.53   7.95   6.16   5.97  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52285  Cystoscopy and treatment                          A   3.60   4.63     4.01     2.01     1.82     0.37   8.60   7.98   5.98   5.79  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52290  Cystoscopy and treatment                          A   4.58   2.46NA   2.19NA   2.46     2.19     0.43   7.47   7.20   7.47   7.20  0000.00.00.0032100       52000 25.5217 090 99      0.00   0.00   0.00
52300  Cystoscopy and treatment                          A   5.30   2.82NA   2.56NA   2.82     2.56     0.56   8.68   8.42   8.68   8.42  0000.00.00.0032000       52000 25.5217 090 99      0.00   0.00   0.00
52301  Cystoscopy and treatment                          A   5.50   2.94NA   2.60NA   2.94     2.60     0.53   8.97   8.63   8.97   8.63  0000.00.00.0032000       52000 25.5217 090 99      0.00   0.00   0.00
52305  Cystoscopy and treatment                          A   5.30   2.72NA   2.42NA   2.72     2.42     0.52   8.54   8.24   8.54   8.24  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52310  Cystoscopy and treatment                          A   2.81   4.39     3.64     1.55     1.38     0.29   7.49   6.74   4.65   4.48  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52315  Cystoscopy and treatment                          A   5.20   7.42     6.02     2.70     2.40     0.50  13.12  11.72   8.40   8.10  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52317  Remove bladder stone                              A   6.71  19.81    15.18     3.29     2.91     0.65  27.17  22.54  10.65  10.27  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52318  Remove bladder stone                              A   9.18   4.45NA   3.94NA   4.45     3.94     0.88  14.51  14.00  14.51  14.00  0000.00.00.0030100       52000 25.5217 090 99      0.00   0.00   0.00
52320  Cystoscopy and treatment                          A   4.69   2.41NA   2.14NA   2.41     2.14     0.45   7.55   7.28   7.55   7.28  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52325  Cystoscopy stone removal                          A   6.15   3.07NA   2.73NA   3.07     2.73     0.60   9.82   9.48   9.82   9.48  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52327  Cystoscopy inject material                        A   5.18   2.33NA   2.06NA   2.33     2.06     0.52   8.03   7.76   8.03   7.76  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52330  Cystoscopy and treatment                          A   5.03  14.37     8.37     2.56     2.27     0.49  19.89  13.89   8.08   7.79  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52332  Cystoscopy and treatment                          A   1.47  11.72    10.39     1.39     0.95     0.15  13.34  12.01   3.01   2.57  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52334  Create passage to kidney                          A   4.82   2.56NA   2.28NA   2.56     2.28     0.48   7.86   7.58   7.86   7.58  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52341  Cysto w/ureter stricture tx                       A   5.35   3.01NA   2.64NA   3.01     2.64     0.52   8.88   8.51   8.88   8.51  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52342  Cysto w/up stricture tx                           A   5.85   3.23NA   2.84NA   3.23     2.84     0.56   9.64   9.25   9.64   9.25  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52343  Cysto w/renal stricture tx                        A   6.55   3.55NA   3.12NA   3.55     3.12     0.64  10.74  10.31  10.74  10.31  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52344  Cysto/uretero stricture tx                        A   7.05   3.92NA   3.46NA   3.92     3.46     0.68  11.65  11.19  11.65  11.19  0000.00.00.0031100       52000 25.5217 090 99      0.00   0.00   0.00
52345  Cysto/uretero w/up stricture                      A   7.55   4.15NA   3.66NA   4.15     3.66     0.72  12.42  11.93  12.42  11.93  0000.00.00.0030000       52351 25.5217 090 99      0.00   0.00   0.00
52346  Cystouretero w/renal strict                       A   8.58   4.61NA   4.05NA   4.61     4.05     0.83  14.02  13.46  14.02  13.46  0000.00.00.0030000       52351 25.5217 090 99      0.00   0.00   0.00
52351  Cystouretero & or pyeloscope                      A   5.85   3.20NA   2.85NA   3.20     2.85     0.56   9.61   9.26   9.61   9.26  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
52352  Cystouretero w/stone remove                       A   6.87   3.75NA   3.34NA   3.75     3.34     0.67  11.29  10.88  11.29  10.88  0000.00.00.0031100       52351 25.5217 090 99      0.00   0.00   0.00
52353  Cystouretero w/lithotripsy                        A   7.96   4.24NA   3.76NA   4.24     3.76     0.76  12.96  12.48  12.96  12.48  0000.00.00.0031100       52351 25.5217 090 99      0.00   0.00   0.00
52354  Cystouretero w/biopsy                             A   7.33   3.96NA   3.52NA   3.96     3.52     0.71  12.00  11.56  12.00  11.56  0000.00.00.0031100       52351 25.5217 090 99      0.00   0.00   0.00
52355  Cystouretero w/excise tumor                       A   8.81   4.62NA   4.10NA   4.62     4.10     0.86  14.29  13.77  14.29  13.77  0000.00.00.0031100       52351 25.5217 090 99      0.00   0.00   0.00
52400  Cystouretero w/congen repr                        A   8.69   5.13NA   4.52NA   5.13     4.52     0.84  14.66  14.05  14.66  14.05  0090.08.83.0930100       52000 25.5217 090 99      0.00   0.00   0.00
52402  Cystourethro cut ejacul duct                      A   5.27   2.40NA   2.12NA   2.40     2.12     0.50   8.17   7.89   8.17   7.89  0000.00.00.0030000       52000 25.5217 090 99      0.00   0.00   0.00
52450  Incision of prostate                              A   7.78   5.77NA   5.19NA   5.77     5.19     0.75  14.30  13.72  14.30  13.72  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
52500  Revision of bladder neck                          A   8.14   5.96NA   5.33NA   5.96     5.33     0.77  14.87  14.24  14.87  14.24  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
52601  Prostatectomy (TURP)                              A  15.26   8.72NA   8.09NA   8.72     8.09     1.49  25.47  24.84  25.47  24.84  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
52630  Remove prostate regrowth                          A   7.73   5.05NA   4.56NA   5.05     4.56     0.75  13.53  13.04  13.53  13.04  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
52640  Relieve bladder contracture                       A   4.79   3.82NA   3.33NA   3.82     3.33     0.45   9.06   8.57   9.06   8.57  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
52647  Laser surgery of prostate                         A  11.30  48.90    37.09     7.31     6.57     1.10  61.30  49.49  19.71  18.97  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
52648  Laser surgery of prostate                         A  12.15  49.44    37.66     7.68     6.91     1.20  62.79  51.01  21.03  20.26  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
52649  Prostate laser enucleation                        A  17.29  10.52NA   8.96NA  10.52     8.96     1.67  29.48  27.92  29.48  27.92  0090.08.83.0920000             25.5217 090 99      0.00   0.00   0.00
52700  Drainage of prostate abscess                      A   7.49   5.10NA   4.68NA   5.10     4.68     0.72  13.31  12.89  13.31  12.89  0090.08.83.0920000             25.5217 090 99      0.00   0.00   0.00
53000  Incision of urethra                               A   2.33   1.97NA   1.75NA   1.97     1.75     0.24   4.54   4.32   4.54   4.32  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
53010  Incision of urethra                               A   4.45   4.10NA   3.67NA   4.10     3.67     0.42   8.97   8.54   8.97   8.54  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
53020  Incision of urethra                               A   1.77   1.02NA   0.91NA   1.02     0.91     0.18   2.97   2.86   2.97   2.86  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53025  Incision of urethra                               A   1.13   0.81NA   0.84NA   0.81     0.84     0.07   2.01   2.04   2.01   2.04  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
53040  Drainage of urethra abscess                       A   6.55   4.75NA   4.28NA   4.75     4.28     0.64  11.94  11.47  11.94  11.47  0090.08.83.0920000             25.5217 090 99      0.00   0.00   0.00
53060  Drainage of urethra abscess                       A   2.68   2.45     2.41     1.86     1.90     0.43   5.56   5.52   4.97   5.01  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
53080  Drainage of urinary leakage                       A   6.92   5.45NA   4.67NA   5.45     4.67     0.67  13.04  12.26  13.04  12.26  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
53085  Drainage of urinary leakage                       A  11.18   6.85NA   6.73NA   6.85     6.73     1.45  19.48  19.36  19.48  19.36  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53200  Biopsy of urethra                                 A   2.59   1.86     1.69     1.44     1.33     0.27   4.72   4.55   4.30   4.19  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53210  Removal of urethra                                A  13.72   8.47NA   7.72NA   8.47     7.72     1.32  23.51  22.76  23.51  22.76  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53215  Removal of urethra                                A  16.85   9.86NA   8.80NA   9.86     8.80     1.63  28.34  27.28  28.34  27.28  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53220  Treatment of urethra lesion                       A   7.63   5.44NA   4.96NA   5.44     4.96     0.73  13.80  13.32  13.80  13.32  0090.08.83.0920000             25.5217 090 99      0.00   0.00   0.00
53230  Removal of urethra lesion                         A  10.44   6.90NA   6.31NA   6.90     6.31     1.17  18.51  17.92  18.51  17.92  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53235  Removal of urethra lesion                         A  10.99   7.31NA   6.47NA   7.31     6.47     1.06  19.36  18.52  19.36  18.52  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53240  Surgery for urethra pouch                         A   7.08   5.23NA   4.63NA   5.23     4.63     0.68  12.99  12.39  12.99  12.39  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
53250  Removal of urethra gland                          A   6.52   5.16NA   4.85NA   5.16     4.85     1.41  13.09  12.78  13.09  12.78  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
53260  Treatment of urethra lesion                       A   3.03   2.74     2.51     2.06     1.95     0.35   6.12   5.89   5.44   5.33  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
53265  Treatment of urethra lesion                       A   3.17   3.19     2.81     2.14     1.97     0.34   6.70   6.32   5.65   5.48  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
53270  Removal of urethra gland                          A   3.14   2.79     2.66     2.15     2.12     0.53   6.46   6.33   5.82   5.79  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
53275  Repair of urethra defect                          A   4.57   3.01NA   2.67NA   3.01     2.67     0.45   8.03   7.69   8.03   7.69  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
53400  Revise urethra stage 1                            A  14.13   8.89NA   8.03NA   8.89     8.03     1.41  24.43  23.57  24.43  23.57  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53405  Revise urethra stage 2                            A  15.66   9.52NA   8.46NA   9.52     8.46     1.52  26.70  25.64  26.70  25.64  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53410  Reconstruction of urethra                         A  17.68  10.49NA   9.40NA  10.49     9.40     1.71  29.88  28.79  29.88  28.79  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53415  Reconstruction of urethra                         A  20.70  11.71NA  10.50NA  11.71    10.50     2.04  34.45  33.24  34.45  33.24  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53420  Reconstruct urethra stage 1                       A  15.17   8.36NA   8.06NA   8.36     8.06     1.48  25.01  24.71  25.01  24.71  0090.08.83.0920110             25.5217 090 99      0.00   0.00   0.00
53425  Reconstruct urethra stage 2                       A  17.07   9.94NA   8.81NA   9.94     8.81     1.64  28.65  27.52  28.65  27.52  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53430  Reconstruction of urethra                         A  17.43   9.89NA   9.24NA   9.89     9.24     1.97  29.29  28.64  29.29  28.64  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53431  Reconstruct urethra/bladder                       A  21.18  11.94NA  10.71NA  11.94    10.71     2.04  35.16  33.93  35.16  33.93  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53440  Male sling procedure                              A  15.54   9.82NA   8.88NA   9.82     8.88     1.52  26.88  25.94  26.88  25.94  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53442  Remove/revise male sling                          A  13.49   8.96NA   8.13NA   8.96     8.13     1.30  23.75  22.92  23.75  22.92  0090.08.83.0920200             25.5217 090 99      0.00   0.00   0.00
53444  Insert tandem cuff                                A  14.19   8.66NA   7.72NA   8.66     7.72     1.37  24.22  23.28  24.22  23.28  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53445  Insert uro/ves nck sphincter                      A  15.39   9.93NA   8.82NA   9.93     8.82     1.51  26.83  25.72  26.83  25.72  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53446  Remove uro sphincter                              A  11.02   7.53NA   6.71NA   7.53     6.71     1.09  19.64  18.82  19.64  18.82  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53447  Remove/replace ur sphincter                       A  14.28   9.06NA   8.05NA   9.06     8.05     1.40  24.74  23.73  24.74  23.73  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53448  Remov/replc ur sphinctr comp                      A  23.44  13.37NA  11.93NA  13.37    11.93     2.25  39.06  37.62  39.06  37.62  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53449  Repair uro sphincter                              A  10.56   7.09NA   6.32NA   7.09     6.32     1.05  18.70  17.93  18.70  17.93  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53450  Revision of urethra                               A   6.77   5.04NA   4.50NA   5.04     4.50     0.65  12.46  11.92  12.46  11.92  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
53460  Revision of urethra                               A   7.75   5.47NA   4.88NA   5.47     4.88     0.73  13.95  13.36  13.95  13.36  0090.08.83.0920000             25.5217 090 99      0.00   0.00   0.00
53500  Urethrlys transvag w/ scope                       A  13.00   8.29NA   7.63NA   8.29     7.63     1.49  22.78  22.12  22.78  22.12  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
53502  Repair of urethra injury                          A   8.26   5.70NA   5.17NA   5.70     5.17     0.80  14.76  14.23  14.76  14.23  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
53505  Repair of urethra injury                          A   8.26   5.77NA   5.15NA   5.77     5.15     0.80  14.83  14.21  14.83  14.21  0090.08.83.0920200             25.5217 090 99      0.00   0.00   0.00
53510  Repair of urethra injury                          A  10.96   7.24NA   6.46NA   7.24     6.46     1.06  19.26  18.48  19.26  18.48  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53515  Repair of urethra injury                          A  14.22   8.61NA   7.75NA   8.61     7.75     1.37  24.20  23.34  24.20  23.34  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
53520  Repair of urethra defect                          A   9.48   6.57NA   5.88NA   6.57     5.88     0.91  16.96  16.27  16.96  16.27  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
53600  Dilate urethra stricture                          A   1.21   1.25     1.07     0.63     0.56     0.11   2.57   2.39   1.95   1.88  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53601  Dilate urethra stricture                          A   0.98   1.45     1.24     0.56     0.50     0.08   2.51   2.30   1.62   1.56  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53605  Dilate urethra stricture                          A   1.28   0.57NA   0.51NA   0.57     0.51     0.12   1.97   1.91   1.97   1.91  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53620  Dilate urethra stricture                          A   1.62   1.88     1.56     0.89     0.80     0.16   3.66   3.34   2.67   2.58  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53621  Dilate urethra stricture                          A   1.35   1.98     1.64     0.73     0.65     0.12   3.45   3.11   2.20   2.12  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53660  Dilation of urethra                               A   0.71   1.42     1.21     0.48     0.44     0.07   2.20   1.99   1.26   1.22  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53661  Dilation of urethra                               A   0.72   1.38     1.17     0.44     0.40     0.07   2.17   1.96   1.23   1.19  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53665  Dilation of urethra                               A   0.76   0.33NA   0.31NA   0.33     0.31     0.08   1.17   1.15   1.17   1.15  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
53850  Prostatic microwave thermotx                      A  10.08  58.37    43.43     6.25     5.61     0.99  69.44  54.50  17.32  16.68  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
53852  Prostatic rf thermotx                             A  10.83  55.07    40.95     7.06     6.35     1.06  66.96  52.84  18.95  18.24  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
53855  Insert prost urethral stent                       A   1.64  19.37    19.37     0.65     0.65     0.16  21.17  21.17   2.45   2.45  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
53860  Transurethral rf treatment                        A   3.97  38.52    38.52     2.24     2.24     0.68  43.17  43.17   6.89   6.89  0090.08.83.0920000             25.5217 090 99      0.00   0.00   0.00
53899  Urology surgery procedure                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
54000  Slitting of prepuce                               A   1.59   2.93     2.45     1.54     1.39     0.14   4.66   4.18   3.27   3.12  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
54001  Slitting of prepuce                               A   2.24   3.31     2.81     1.76     1.59     0.23   5.78   5.28   4.23   4.06  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54015  Drain penis lesion                                A   5.36   3.49NA   3.10NA   3.49     3.10     0.56   9.41   9.02   9.41   9.02  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
54050  Destruction penis lesion(s)                       A   1.29   2.44     2.40     1.65     1.67     0.16   3.89   3.85   3.10   3.12  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54055  Destruction penis lesion(s)                       A   1.25   2.16     2.01     1.36     1.32     0.14   3.55   3.40   2.75   2.71  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54056  Cryosurgery penis lesion(s)                       A   1.29   2.69     2.72     1.81     1.87     0.18   4.16   4.19   3.28   3.34  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54057  Laser surg penis lesion(s)                        A   1.29   2.76     2.47     1.42     1.33     0.12   4.17   3.88   2.83   2.74  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54060  Excision of penis lesion(s)                       A   1.98   3.38     2.94     1.75     1.62     0.22   5.58   5.14   3.95   3.82  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54065  Destruction penis lesion(s)                       A   2.47   3.74     3.65     2.32     2.38     0.31   6.52   6.43   5.10   5.16  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54100  Biopsy of penis                                   A   1.90   3.79     3.62     1.62     1.69     0.24   5.93   5.76   3.76   3.83  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
54105  Biopsy of penis                                   A   3.54   4.37     3.70     2.64     2.34     0.35   8.26   7.59   6.53   6.23  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54110  Treatment of penis lesion                         A  10.92   7.03NA   6.31NA   7.03     6.31     1.06  19.01  18.29  19.01  18.29  0090.10.80.1020200             25.5217 090 99      0.00   0.00   0.00
54111  Treat penis lesion graft                          A  14.42   8.63NA   7.69NA   8.63     7.69     1.40  24.45  23.51  24.45  23.51  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54112  Treat penis lesion graft                          A  16.98  10.05NA   8.92NA  10.05     8.92     1.63  28.66  27.53  28.66  27.53  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54115  Treatment of penis lesion                         A   6.95   6.15     5.47     5.28     4.75     0.67  13.77  13.09  12.90  12.37  0090.10.80.1020200             25.5217 090 99      0.00   0.00   0.00
54120  Partial removal of penis                          A  11.01   7.18NA   6.43NA   7.18     6.43     1.09  19.28  18.53  19.28  18.53  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54125  Removal of penis                                  A  14.56   8.77NA   7.88NA   8.77     7.88     1.48  24.81  23.92  24.81  23.92  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54130  Remove penis & nodes                              A  21.84  12.47NA  11.13NA  12.47    11.13     2.12  36.43  35.09  36.43  35.09  0090.10.80.1022210             25.5217 090 99      0.00   0.00   0.00
54135  Remove penis & nodes                              A  28.17  15.29NA  13.62NA  15.29    13.62     2.73  46.19  44.52  46.19  44.52  0090.10.80.1022200             25.5217 090 99      0.00   0.00   0.00
54150  Circumcision w/regionl block                      A   1.90   2.84     2.34     0.86     0.80     0.23   4.97   4.47   2.99   2.93  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
54160  Circumcision neonate                              A   2.53   4.14     3.46     1.62     1.44     0.24   6.91   6.23   4.39   4.21  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54161  Circum 28 days or older                           A   3.32   2.35NA   2.11NA   2.35     2.11     0.34   6.01   5.77   6.01   5.77  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54162  Lysis penil circumic lesion                       A   3.32   4.44     3.73     2.39     2.18     0.33   8.09   7.38   6.04   5.83  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54163  Repair of circumcision                            A   3.32   3.03NA   2.72NA   3.03     2.72     0.33   6.68   6.37   6.68   6.37  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54164  Frenulotomy of penis                              A   2.82   2.79NA   2.50NA   2.79     2.50     0.29   5.90   5.61   5.90   5.61  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54200  Treatment of penis lesion                         A   1.11   2.12     1.83     1.36     1.21     0.10   3.33   3.04   2.57   2.42  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54205  Treatment of penis lesion                         A   8.97   6.49NA   5.72NA   6.49     5.72     0.86  16.32  15.55  16.32  15.55  0090.10.80.1020200             25.5217 090 99      0.00   0.00   0.00
54220  Treatment of penis lesion                         A   2.42   3.66     3.07     1.44     1.29     0.26   6.34   5.75   4.12   3.97  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
54230  Prepare penis study                               A   1.34   1.48     1.30     0.96     0.86     0.12   2.94   2.76   2.42   2.32  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
54231  Dynamic cavernosometry                            A   2.04   2.04     1.80     1.32     1.17     0.20   4.28   4.04   3.56   3.41  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
54235  Penile injection                                  A   1.19   1.45     1.29     0.94     0.85     0.11   2.75   2.59   2.24   2.15  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
54240  Penis study                                       A   1.31   1.60     1.43     1.60NA   1.43 NA  0.09   3.00   2.83   3.00   2.83  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
54240TCPenis study                                       A   0.00   1.03     0.92     1.03NA   0.92 NA  0.01   1.04   0.93   1.04   0.93  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
5424026Penis study                                       A   1.31   0.57     0.51     0.57     0.51     0.08   1.96   1.90   1.96   1.90  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
54250  Penis study                                       A   2.22   1.33     1.17     1.33NA   1.17 NA  0.15   3.70   3.54   3.70   3.54  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
54250TCPenis study                                       A   0.00   0.34     0.29     0.34NA   0.29 NA  0.01   0.35   0.30   0.35   0.30  1000.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
5425026Penis study                                       A   2.22   0.99     0.88     0.99     0.88     0.14   3.35   3.24   3.35   3.24  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
54300  Revision of penis                                 A  11.20   7.41NA   6.53NA   7.41     6.53     1.09  19.70  18.82  19.70  18.82  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54304  Revision of penis                                 A  13.28   8.46NA   7.43NA   8.46     7.43     1.28  23.02  21.99  23.02  21.99  0090.10.80.1020200             25.5217 090 99      0.00   0.00   0.00
54308  Reconstruction of urethra                         A  12.62   8.49NA   7.89NA   8.49     7.89     1.22  22.33  21.73  22.33  21.73  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54312  Reconstruction of urethra                         A  14.51   9.67NA   8.96NA   9.67     8.96     1.40  25.58  24.87  25.58  24.87  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54316  Reconstruction of urethra                         A  18.05  11.34NA  10.56NA  11.34    10.56     1.74  31.13  30.35  31.13  30.35  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54318  Reconstruction of urethra                         A  12.43   8.53NA   7.97NA   8.53     7.97     0.87  21.83  21.27  21.83  21.27  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54322  Reconstruction of urethra                         A  13.98   8.64NA   7.59NA   8.64     7.59     1.36  23.98  22.93  23.98  22.93  0090.10.80.1020200             25.5217 090 99      0.00   0.00   0.00
54324  Reconstruction of urethra                         A  17.55  10.51NA   9.22NA  10.51     9.22     1.68  29.74  28.45  29.74  28.45  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54326  Reconstruction of urethra                         A  17.02   9.77NA   9.11NA   9.77     9.11     1.64  28.43  27.77  28.43  27.77  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54328  Revise penis/urethra                              A  16.89  10.11NA   9.06NA  10.11     9.06     1.63  28.63  27.58  28.63  27.58  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54332  Revise penis/urethra                              A  18.37  10.91NA   9.65NA  10.91     9.65     1.78  31.06  29.80  31.06  29.80  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54336  Revise penis/urethra                              A  21.62  12.34NA  12.48NA  12.34    12.48     2.09  36.05  36.19  36.05  36.19  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54340  Secondary urethral surgery                        A   9.71   6.64NA   6.02NA   6.64     6.02     0.92  17.27  16.65  17.27  16.65  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54344  Secondary urethral surgery                        A  17.06  10.89NA  10.12NA  10.89    10.12     1.64  29.59  28.82  29.59  28.82  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54348  Secondary urethral surgery                        A  18.32  14.68NA  16.82NA  14.68    16.82     1.29  34.29  36.43  34.29  36.43  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54352  Reconstruct urethra/penis                         A  26.13  19.83NA  22.83NA  19.83    22.83     2.54  48.50  51.50  48.50  51.50  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54360  Penis plastic surgery                             A  12.78   8.10NA   7.12NA   8.10     7.12     1.24  22.12  21.14  22.12  21.14  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54380  Repair penis                                      A  14.18   8.97NA   7.89NA   8.97     7.89     1.37  24.52  23.44  24.52  23.44  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54385  Repair penis                                      A  16.56  11.07NA   9.07NA  11.07     9.07     2.42  30.05  28.05  30.05  28.05  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54390  Repair penis and bladder                          A  22.77  12.46NA  12.79NA  12.46    12.79     2.20  37.43  37.76  37.43  37.76  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54400  Insert semi-rigid prosthesis                      A   9.17   6.15NA   5.45NA   6.15     5.45     0.88  16.20  15.50  16.20  15.50  0090.10.80.1020110             25.5217 090 99      0.00   0.00   0.00
54401  Insert self-contd prosthesis                      A  10.44   8.56NA   7.63NA   8.56     7.63     1.03  20.03  19.10  20.03  19.10  0090.10.80.1020110             25.5217 090 99      0.00   0.00   0.00
54405  Insert multi-comp penis pros                      A  14.52   8.78NA   7.84NA   8.78     7.84     1.41  24.71  23.77  24.71  23.77  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54406  Remove muti-comp penis pros                       A  12.89   8.15NA   7.28NA   8.15     7.28     1.25  22.29  21.42  22.29  21.42  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54408  Repair multi-comp penis pros                      A  13.91   8.83NA   7.93NA   8.83     7.93     1.37  24.11  23.21  24.11  23.21  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54410  Remove/replace penis prosth                       A  15.18   9.62NA   8.57NA   9.62     8.57     1.48  26.28  25.23  26.28  25.23  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54411  Remov/replc penis pros comp                       A  18.35  11.16NA  10.02NA  11.16    10.02     1.78  31.29  30.15  31.29  30.15  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54415  Remove self-contd penis pros                      A   8.88   6.37NA   5.70NA   6.37     5.70     0.86  16.11  15.44  16.11  15.44  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54416  Remv/repl penis contain pros                      A  12.08   8.39NA   7.54NA   8.39     7.54     1.18  21.65  20.80  21.65  20.80  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54417  Remv/replc penis pros compl                       A  16.10   9.73NA   8.72NA   9.73     8.72     1.56  27.39  26.38  27.39  26.38  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54420  Revision of penis                                 A  12.39   7.98NA   7.07NA   7.98     7.07     1.21  21.58  20.67  21.58  20.67  0090.10.80.1020200             25.5217 090 99      0.00   0.00   0.00
54430  Revision of penis                                 A  11.06   7.45NA   6.61NA   7.45     6.61     1.07  19.58  18.74  19.58  18.74  0090.10.80.1022200             25.5217 090 99      0.00   0.00   0.00
54435  Revision of penis                                 A   6.81   5.27NA   4.69NA   5.27     4.69     0.65  12.73  12.15  12.73  12.15  0090.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54440  Repair of penis                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
54450  Preputial stretching                              A   1.12   0.95     0.80     0.54     0.47     0.10   2.17   2.02   1.76   1.69  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
54500  Biopsy of testis                                  A   1.31   0.85NA   0.75NA   0.85     0.75     0.12   2.28   2.18   2.28   2.18  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
54505  Biopsy of testis                                  A   3.50   2.60NA   2.29NA   2.60     2.29     0.34   6.44   6.13   6.44   6.13  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
54512  Excise lesion testis                              A   9.33   6.10NA   5.52NA   6.10     5.52     0.92  16.35  15.77  16.35  15.77  0090.10.80.1021110             25.5217 090 99      0.00   0.00   0.00
54520  Removal of testis                                 A   5.30   4.04NA   3.68NA   4.04     3.68     0.61   9.95   9.59   9.95   9.59  0090.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
54522  Orchiectomy partial                               A  10.25   6.50NA   6.04NA   6.50     6.04     1.00  17.75  17.29  17.75  17.29  0090.10.80.1021210             25.5217 090 99      0.00   0.00   0.00
54530  Removal of testis                                 A   8.46   6.11NA   5.47NA   6.11     5.47     0.87  15.44  14.80  15.44  14.80  0090.10.80.1021210             25.5217 090 99      0.00   0.00   0.00
54535  Extensive testis surgery                          A  13.19   8.01NA   7.36NA   8.01     7.36     1.28  22.48  21.83  22.48  21.83  0090.10.80.1021200             25.5217 090 99      0.00   0.00   0.00
54550  Exploration for testis                            A   8.41   5.71NA   5.17NA   5.71     5.17     0.81  14.93  14.39  14.93  14.39  0090.10.80.1021200             25.5217 090 99      0.00   0.00   0.00
54560  Exploration for testis                            A  12.10   7.25NA   6.86NA   7.25     6.86     1.18  20.53  20.14  20.53  20.14  0090.10.80.1021210             25.5217 090 99      0.00   0.00   0.00
54600  Reduce testis torsion                             A   7.64   5.42NA   4.86NA   5.42     4.86     0.73  13.79  13.23  13.79  13.23  0090.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
54620  Suspension of testis                              A   5.21   3.47NA   3.07NA   3.47     3.07     0.50   9.18   8.78   9.18   8.78  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
54640  Suspension of testis                              A   7.73   5.88NA   5.48NA   5.88     5.48     0.87  14.48  14.08  14.48  14.08  0090.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
54650  Orchiopexy (Fowler-Stephens)                      A  12.39   7.95NA   7.26NA   7.95     7.26     1.21  21.55  20.86  21.55  20.86  0090.10.80.1021200             25.5217 090 99      0.00   0.00   0.00
54660  Revision of testis                                A   5.74   4.56NA   4.12NA   4.56     4.12     0.54  10.84  10.40  10.84  10.40  0090.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
54670  Repair testis injury                              A   6.65   5.03NA   4.53NA   5.03     4.53     0.64  12.32  11.82  12.32  11.82  0090.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
54680  Relocation of testis(es)                          A  14.04   8.42NA   7.70NA   8.42     7.70     1.36  23.82  23.10  23.82  23.10  0090.10.80.1021210             25.5217 090 99      0.00   0.00   0.00
54690  Laparoscopy orchiectomy                           A  11.70   6.66NA   6.46NA   6.66     6.46     2.47  20.83  20.63  20.83  20.63  0090.10.80.1021210             25.5217 090 99      0.00   0.00   0.00
54692  Laparoscopy orchiopexy                            A  13.74   8.13NA   7.23NA   8.13     7.23     1.32  23.19  22.29  23.19  22.29  0090.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
54699  Laparoscope proc testis                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
54700  Drainage of scrotum                               A   3.47   2.62NA   2.40NA   2.62     2.40     0.39   6.48   6.26   6.48   6.26  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54800  Biopsy of epididymis                              A   2.33   1.82NA   2.07NA   1.82     2.07     0.33   4.48   4.73   4.48   4.73  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
54830  Remove epididymis lesion                          A   6.01   4.71NA   4.26NA   4.71     4.26     0.62  11.34  10.89  11.34  10.89  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
54840  Remove epididymis lesion                          A   5.27   4.03NA   3.59NA   4.03     3.59     0.52   9.82   9.38   9.82   9.38  0090.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54860  Removal of epididymis                             A   6.95   5.13NA   4.61NA   5.13     4.61     0.68  12.76  12.24  12.76  12.24  0090.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
54861  Removal of epididymis                             A   9.70   6.59NA   5.92NA   6.59     5.92     0.92  17.21  16.54  17.21  16.54  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
54865  Explore epididymis                                A   5.77   4.57NA   4.13NA   4.57     4.13     0.56  10.90  10.46  10.90  10.46  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
54900  Fusion of spermatic ducts                         A  14.20   8.03NA   7.90NA   8.03     7.90     1.02  23.25  23.12  23.25  23.12  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
54901  Fusion of spermatic ducts                         A  19.10  11.87NA  11.17NA  11.87    11.17     1.36  32.33  31.63  32.33  31.63  0090.10.80.1022000             25.5217 090 99      0.00   0.00   0.00
55000  Drainage of hydrocele                             A   1.43   2.07     1.79     1.00     0.92     0.14   3.64   3.36   2.57   2.49  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
55040  Removal of hydrocele                              A   5.45   4.26NA   3.86NA   4.26     3.86     0.61  10.32   9.92  10.32   9.92  0090.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
55041  Removal of hydroceles                             A   8.54   6.09NA   5.52NA   6.09     5.52     0.90  15.53  14.96  15.53  14.96  0090.10.80.1022100             25.5217 090 99      0.00   0.00   0.00
55060  Repair of hydrocele                               A   6.15   4.76NA   4.33NA   4.76     4.33     0.67  11.58  11.15  11.58  11.15  0090.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
55100  Drainage of scrotum abscess                       A   2.45   3.88     3.42     2.28     2.12     0.30   6.63   6.17   5.03   4.87  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
55110  Explore scrotum                                   A   6.33   4.81NA   4.39NA   4.81     4.39     0.68  11.82  11.40  11.82  11.40  0090.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
55120  Removal of scrotum lesion                         A   5.72   4.51NA   4.10NA   4.51     4.10     0.61  10.84  10.43  10.84  10.43  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
55150  Removal of scrotum                                A   8.14   5.94NA   5.41NA   5.94     5.41     0.86  14.94  14.41  14.94  14.41  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55175  Revision of scrotum                               A   5.87   4.63NA   4.19NA   4.63     4.19     0.60  11.10  10.66  11.10  10.66  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
55180  Revision of scrotum                               A  11.78   7.98NA   7.32NA   7.98     7.32     1.29  21.05  20.39  21.05  20.39  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
55200  Incision of sperm duct                            A   4.55   9.22     7.35     3.43     3.13     0.43  14.20  12.33   8.41   8.11  0090.10.80.1022000             25.5217 090 99      0.00   0.00   0.00
55250  Removal of sperm duct(s)                          A   3.37   8.98     7.32     3.25     2.96     0.33  12.68  11.02   6.95   6.66  0090.10.80.1022100             25.5217 090 99      0.00   0.00   0.00
55300  Prepare sperm duct x-ray                          A   3.50   1.73NA   1.68NA   1.73     1.68     0.34   5.57   5.52   5.57   5.52  0000.00.00.0022000             25.5217 090 99      0.00   0.00   0.00
55400  Repair of sperm duct                              A   8.61   5.81NA   5.15NA   5.81     5.15     0.83  15.25  14.59  15.25  14.59  0090.10.80.1021210             25.5217 090 99      0.00   0.00   0.00
55450  Ligation of sperm duct                            A   4.43   6.47     5.38     2.94     2.68     0.42  11.32  10.23   7.79   7.53  0010.10.80.1022000             25.5217 090 99      0.00   0.00   0.00
55500  Removal of hydrocele                              A   6.22   4.80NA   4.67NA   4.80     4.67     0.88  11.90  11.77  11.90  11.77  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
55520  Removal of sperm cord lesion                      A   6.66   5.00NA   5.38NA   5.00     5.38     1.36  13.02  13.40  13.02  13.40  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55530  Revise spermatic cord veins                       A   5.75   4.41NA   3.98NA   4.41     3.98     0.62  10.78  10.35  10.78  10.35  0090.10.80.1021110             25.5217 090 99      0.00   0.00   0.00
55535  Revise spermatic cord veins                       A   7.19   5.17NA   4.69NA   5.17     4.69     0.69  13.05  12.57  13.05  12.57  0090.10.80.1021210             25.5217 090 99      0.00   0.00   0.00
55540  Revise hernia & sperm veins                       A   8.30   5.68NA   6.11NA   5.68     6.11     1.64  15.62  16.05  15.62  16.05  0090.10.80.1021110             25.5217 090 99      0.00   0.00   0.00
55550  Laparo ligate spermatic vein                      A   7.20   5.02NA   4.62NA   5.02     4.62     0.69  12.91  12.51  12.91  12.51  0090.10.80.1021210             25.5217 090 99      0.00   0.00   0.00
55559  Laparo proc spermatic cord                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
55600  Incise sperm duct pouch                           A   7.01   5.17NA   4.62NA   5.17     4.62     0.68  12.86  12.31  12.86  12.31  0090.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
55605  Incise sperm duct pouch                           A   8.76   6.24NA   6.21NA   6.24     6.21     0.84  15.84  15.81  15.84  15.81  0090.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
55650  Remove sperm duct pouch                           A  12.65   7.88NA   7.16NA   7.88     7.16     1.22  21.75  21.03  21.75  21.03  0090.10.80.1021210             25.5217 090 99      0.00   0.00   0.00
55680  Remove sperm pouch lesion                         A   5.67   4.17NA   3.88NA   4.17     3.88     0.54  10.38  10.09  10.38  10.09  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
55700  Biopsy of prostate                                A   2.58   4.04     3.37     1.39     1.28     0.26   6.88   6.21   4.23   4.12  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
55705  Biopsy of prostate                                A   4.61   3.11NA   2.75NA   3.11     2.75     0.45   8.17   7.81   8.17   7.81  0010.10.80.1020110             25.5217 090 99      0.00   0.00   0.00
55706  Prostate saturation sampling                      A   6.28   4.69NA   4.01NA   4.69     4.01     0.43  11.40  10.72  11.40  10.72  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55720  Drainage of prostate abscess                      A   7.73   5.29NA   4.75NA   5.29     4.75     0.73  13.75  13.21  13.75  13.21  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55725  Drainage of prostate abscess                      A  10.05   6.96NA   6.33NA   6.96     6.33     0.98  17.99  17.36  17.99  17.36  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55801  Removal of prostate                               A  19.80  11.49NA  10.41NA  11.49    10.41     1.91  33.20  32.12  33.20  32.12  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55810  Extensive prostate surgery                        A  24.29  13.39NA  12.08NA  13.39    12.08     2.47  40.15  38.84  40.15  38.84  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55812  Extensive prostate surgery                        A  29.89  16.28NA  14.59NA  16.28    14.59     2.91  49.08  47.39  49.08  47.39  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55815  Extensive prostate surgery                        A  32.95  17.67NA  15.80NA  17.67    15.80     3.19  53.81  51.94  53.81  51.94  0090.10.80.1022210             25.5217 090 99      0.00   0.00   0.00
55821  Removal of prostate                               A  15.76   9.37NA   8.40NA   9.37     8.40     1.55  26.68  25.71  26.68  25.71  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55831  Removal of prostate                               A  17.19  10.01NA   8.95NA  10.01     8.95     1.66  28.86  27.80  28.86  27.80  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55840  Extensive prostate surgery                        A  24.63  13.80NA  12.35NA  13.80    12.35     2.40  40.83  39.38  40.83  39.38  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55842  Extensive prostate surgery                        A  26.49  14.65NA  13.08NA  14.65    13.08     2.59  43.73  42.16  43.73  42.16  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55845  Extensive prostate surgery                        A  30.67  16.26NA  14.54NA  16.26    14.54     3.03  49.96  48.24  49.96  48.24  0090.10.80.1022210             25.5217 090 99      0.00   0.00   0.00
55860  Surgical exposure prostate                        A  15.84   9.33NA   8.32NA   9.33     8.32     1.52  26.69  25.68  26.69  25.68  0090.10.80.1020110             25.5217 090 99      0.00   0.00   0.00
55862  Extensive prostate surgery                        A  20.04  11.56NA  10.27NA  11.56    10.27     1.93  33.53  32.24  33.53  32.24  0090.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
55865  Extensive prostate surgery                        A  24.57  13.83NA  12.31NA  13.83    12.31     2.38  40.78  39.26  40.78  39.26  0090.10.80.1022210             25.5217 090 99      0.00   0.00   0.00
55866  Laparo radical prostatectomy                      A  32.06  17.65NA  16.00NA  17.65    16.00     3.18  52.89  51.24  52.89  51.24  0090.08.83.0920210             25.5217 090 99      0.00   0.00   0.00
55870  Electroejaculation                                A   2.58   2.51     2.24     1.54     1.35     0.26   5.35   5.08   4.38   4.19  0000.00.00.0020110             25.5217 090 99      0.00   0.00   0.00
55873  Cryoablate prostate                               A  13.60 172.34   172.34    10.58     7.50     1.36 187.30 187.30  25.54  22.46  0090.08.83.0920100             25.5217 090 99      0.00   0.00   0.00
55875  Transperi needle place pros                       A  13.46   8.50NA   7.62NA   8.50     7.62     1.29  23.25  22.37  23.25  22.37  0090.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
55876  Place rt device/marker pros                       A   1.73   2.27     1.98     1.20     1.05     0.16   4.16   3.87   3.09   2.94  0000.00.00.0020111             25.5217 090 99      0.00   0.00   0.00
55899  Genital surgery procedure                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
55920  Place needles pelvic for rt                       A   8.31   4.15NA   4.10NA   4.15     4.10     0.80  13.26  13.21  13.26  13.21  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
55970  Sex transformation m to f                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
55980  Sex transformation f to m                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
56405  I & D of vulva/perineum                           A   1.49   1.50     1.50     1.45     1.48     0.26   3.25   3.25   3.20   3.23  0010.10.80.1020120             25.5217 090 99      0.00   0.00   0.00
56420  Drainage of gland abscess                         A   1.44   1.99     1.88     1.05     1.05     0.24   3.67   3.56   2.73   2.73  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
56440  Surgery for vulva lesion                          A   2.89   2.06NA   2.12NA   2.06     2.12     0.49   5.44   5.50   5.44   5.50  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
56441  Lysis of labial lesion(s)                         A   2.02   2.04     1.93     1.84     1.78     0.29   4.35   4.24   4.15   4.09  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
56442  Hymenotomy                                        A   0.68   0.64NA   0.64NA   0.64     0.64     0.11   1.43   1.43   1.43   1.43  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
56501  Destroy vulva lesions sim                         A   1.58   2.03     2.00     1.55     1.57     0.27   3.88   3.85   3.40   3.42  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
56515  Destroy vulva lesion/s compl                      A   3.08   3.06     3.10     2.32     2.43     0.50   6.64   6.68   5.90   6.01  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
56605  Biopsy of vulva/perineum                          A   1.10   1.17     1.15     0.52     0.56     0.18   2.45   2.43   1.80   1.84  0000.00.00.0020120             25.5217 090 99      0.00   0.00   0.00
56606  Biopsy of vulva/perineum                          A   0.55   0.48     0.47     0.24     0.26     0.08   1.11   1.10   0.87   0.89  0ZZZ.00.00.0000120             25.5217 090 99      0.00   0.00   0.00
56620  Partial removal of vulva                          A   7.53   6.06NA   6.29NA   6.06     6.29     1.26  14.85  15.08  14.85  15.08  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
56625  Complete removal of vulva                         A   9.68   6.53NA   6.86NA   6.53     6.86     1.62  17.83  18.16  17.83  18.16  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
56630  Extensive vulva surgery                           A  14.80   8.83NA   9.47NA   8.83     9.47     2.55  26.18  26.82  26.18  26.82  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
56631  Extensive vulva surgery                           A  18.99  10.98NA  11.79NA  10.98    11.79     3.20  33.17  33.98  33.17  33.98  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
56632  Extensive vulva surgery                           A  21.86  13.01NA  14.10NA  13.01    14.10     3.69  38.56  39.65  38.56  39.65  0090.12.74.1422220             25.5217 090 99      0.00   0.00   0.00
56633  Extensive vulva surgery                           A  19.62  11.10NA  11.96NA  11.10    11.96     3.31  34.03  34.89  34.03  34.89  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
56634  Extensive vulva surgery                           A  20.66  11.83NA  12.79NA  11.83    12.79     3.49  35.98  36.94  35.98  36.94  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
56637  Extensive vulva surgery                           A  24.75  13.42NA  14.49NA  13.42    14.49     4.17  42.34  43.41  42.34  43.41  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
56640  Extensive vulva surgery                           A  24.78  12.80NA  13.71NA  12.80    13.71     4.17  41.75  42.66  41.75  42.66  0090.12.74.1421210             25.5217 090 99      0.00   0.00   0.00
56700  Partial removal of hymen                          A   2.84   2.25NA   2.29NA   2.25     2.29     0.48   5.57   5.61   5.57   5.61  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
56740  Remove vagina gland lesion                        A   4.88   3.13NA   3.28NA   3.13     3.28     0.83   8.84   8.99   8.84   8.99  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
56800  Repair of vagina                                  A   3.93   2.62NA   2.67NA   2.62     2.67     0.64   7.19   7.24   7.19   7.24  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
56805  Repair clitoris                                   A  19.88  10.84NA  11.34NA  10.84    11.34     3.37  34.09  34.59  34.09  34.59  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
56810  Repair of perineum                                A   4.29   2.75NA   2.85NA   2.75     2.85     0.69   7.73   7.83   7.73   7.83  0010.10.80.1020220             25.5217 090 99      0.00   0.00   0.00
56820  Exam of vulva w/scope                             A   1.50   1.52     1.52     0.77     0.83     0.26   3.28   3.28   2.53   2.59  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
56821  Exam/biopsy of vulva w/scope                      A   2.05   1.97     1.95     1.02     1.08     0.34   4.36   4.34   3.41   3.47  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57000  Exploration of vagina                             A   3.02   2.14NA   2.17NA   2.14     2.17     0.50   5.66   5.69   5.66   5.69  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
57010  Drainage of pelvic abscess                        A   6.84   4.90NA   5.08NA   4.90     5.08     1.15  12.89  13.07  12.89  13.07  0090.12.74.1420000             25.5217 090 99      0.00   0.00   0.00
57020  Drainage of pelvic fluid                          A   1.50   1.03     1.05     0.67     0.73     0.26   2.79   2.81   2.43   2.49  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
57022  I & d vaginal hematoma pp                         A   2.73   1.81NA   1.88NA   1.81     1.88     0.45   4.99   5.06   4.99   5.06  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
57023  I & d vag hematoma non-ob                         A   5.18   3.22NA   3.35NA   3.22     3.35     0.87   9.27   9.40   9.27   9.40  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
57061  Destroy vag lesions simple                        A   1.30   1.85     1.80     1.38     1.39     0.22   3.37   3.32   2.90   2.91  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57065  Destroy vag lesions complex                       A   2.66   2.58     2.58     1.98     2.03     0.43   5.67   5.67   5.07   5.12  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57100  Biopsy of vagina                                  A   1.20   1.21     1.20     0.55     0.60     0.20   2.61   2.60   1.95   2.00  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57105  Biopsy of vagina                                  A   1.74   1.98     1.93     1.68     1.67     0.29   4.01   3.96   3.71   3.70  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57106  Remove vagina wall partial                        A   7.50   5.54NA   5.74NA   5.54     5.74     1.21  14.25  14.45  14.25  14.45  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57107  Remove vagina tissue part                         A  24.56  13.00NA  13.92NA  13.00    13.92     4.14  41.70  42.62  41.70  42.62  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57109  Vaginectomy partial w/nodes                       A  28.40  14.47NA  15.62NA  14.47    15.62     4.79  47.66  48.81  47.66  48.81  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
57110  Remove vagina wall complete                       A  15.48   8.67NA   9.12NA   8.67     9.12     2.58  26.73  27.18  26.73  27.18  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57111  Remove vagina tissue compl                        A  28.40  14.75NA  15.62NA  14.75    15.62     4.79  47.94  48.81  47.94  48.81  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
57112  Vaginectomy w/nodes compl                         A  30.52  12.01NA   9.63NA  12.01     9.63     2.42  44.95  42.57  44.95  42.57  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
57120  Closure of vagina                                 A   8.28   5.57NA   5.73NA   5.57     5.73     1.36  15.21  15.37  15.21  15.37  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57130  Remove vagina lesion                              A   2.46   2.44     2.40     1.89     1.91     0.41   5.31   5.27   4.76   4.78  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
57135  Remove vagina lesion                              A   2.70   2.56     2.53     1.99     2.02     0.43   5.69   5.66   5.12   5.15  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57150  Treat vagina infection                            A   0.55   0.79     0.69     0.24     0.25     0.08   1.42   1.32   0.87   0.88  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57155  Insert uteri tandems/ovoids                       A   3.37   6.05     6.05     1.69     1.69     0.30   9.72   9.72   5.36   5.36  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57156  Ins vag brachytx device                           A   1.87   2.41     2.41     1.01     1.01     0.16   4.44   4.44   3.04   3.04  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
57160  Insert pessary/other device                       A   0.89   1.24     1.21     0.38     0.41     0.14   2.27   2.24   1.41   1.44  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57170  Fitting of diaphragm/cap                          A   0.91   0.87     0.75     0.38     0.41     0.14   1.92   1.80   1.43   1.46  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
57180  Treat vaginal bleeding                            A   1.63   2.29     2.20     1.26     1.25     0.27   4.19   4.10   3.16   3.15  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57200  Repair of vagina                                  A   4.42   3.72NA   3.77NA   3.72     3.77     0.71   8.85   8.90   8.85   8.90  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57210  Repair vagina/perineum                            A   5.71   4.26NA   4.33NA   4.26     4.33     0.91  10.88  10.95  10.88  10.95  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57220  Revision of urethra                               A   4.85   3.87NA   3.92NA   3.87     3.92     0.80   9.52   9.57   9.52   9.57  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57230  Repair of urethral lesion                         A   6.30   4.55NA   4.55NA   4.55     4.55     1.06  11.91  11.91  11.91  11.91  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57240  Repair bladder & vagina                           A  11.50   6.69NA   6.91NA   6.69     6.91     1.63  19.82  20.04  19.82  20.04  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57250  Repair rectum & vagina                            A  11.50   6.53NA   7.08NA   6.53     7.08     1.86  19.89  20.44  19.89  20.44  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57260  Repair of vagina                                  A  14.44   7.79NA   8.43NA   7.79     8.43     2.34  24.57  25.21  24.57  25.21  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57265  Extensive repair of vagina                        A  15.94   8.56NA   9.10NA   8.56     9.10     2.57  27.07  27.61  27.07  27.61  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57267  Insert mesh/pelvic flr addon                      A   4.88   2.14NA   2.18NA   2.14     2.18     0.72   7.74   7.78   7.74   7.78  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
57268  Repair of bowel bulge                             A   7.57   5.53NA   5.67NA   5.53     5.67     1.22  14.32  14.46  14.32  14.46  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57270  Repair of bowel pouch                             A  13.67   7.83NA   8.21NA   7.83     8.21     2.24  23.74  24.12  23.74  24.12  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57280  Suspension of vagina                              A  16.72   9.19NA   9.45NA   9.19     9.45     2.59  28.50  28.76  28.50  28.76  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57282  Colpopexy extraperitoneal                         A   7.97   5.74NA   5.80NA   5.74     5.80     1.24  14.95  15.01  14.95  15.01  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57283  Colpopexy intraperitoneal                         A  11.66   7.00NA   7.26NA   7.00     7.26     1.91  20.57  20.83  20.57  20.83  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57284  Repair paravag defect open                        A  14.33   8.02NA   8.07NA   8.02     8.07     2.16  24.51  24.56  24.51  24.56  0090.08.83.0920220             25.5217 090 99      0.00   0.00   0.00
57285  Repair paravag defect vag                         A  11.60   6.78NA   6.97NA   6.78     6.97     1.79  20.17  20.36  20.17  20.36  0090.08.83.0920220             25.5217 090 99      0.00   0.00   0.00
57287  Revise/remove sling repair                        A  11.15   7.85NA   7.53NA   7.85     7.53     1.47  20.47  20.15  20.47  20.15  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57288  Repair bladder defect                             A  12.13   7.53NA   7.19NA   7.53     7.19     1.59  21.25  20.91  21.25  20.91  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57289  Repair bladder & vagina                           A  12.80   7.73NA   7.32NA   7.73     7.32     1.24  21.77  21.36  21.77  21.36  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57291  Construction of vagina                            A   8.64   7.54NA   9.10NA   7.54     9.10     1.47  17.65  19.21  17.65  19.21  0090.12.74.1420200             25.5217 090 99      0.00   0.00   0.00
57292  Construct vagina with graft                       A  14.01   8.16NA   8.41NA   8.16     8.41     2.34  24.51  24.76  24.51  24.76  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57295  Revise vag graft via vagina                       A   7.82   5.35NA   5.32NA   5.35     5.32     1.20  14.37  14.34  14.37  14.34  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57296  Revise vag graft open abd                         A  16.56   8.98NA   9.49NA   8.98     9.49     2.78  28.32  28.83  28.32  28.83  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57300  Repair rectum-vagina fistula                      A   8.71   6.03NA   6.50NA   6.03     6.50     1.52  16.26  16.73  16.26  16.73  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57305  Repair rectum-vagina fistula                      A  15.35   8.78NA   9.64NA   8.78     9.64     2.96  27.09  27.95  27.09  27.95  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57307  Fistula repair & colostomy                        A  17.17   9.94NA  11.04NA   9.94    11.04     3.67  30.78  31.88  30.78  31.88  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57308  Fistula repair transperine                        A  10.59   6.84NA   7.43NA   6.84     7.43     1.79  19.22  19.81  19.22  19.81  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57310  Repair urethrovaginal lesion                      A   7.65   5.50NA   5.05NA   5.50     5.05     0.73  13.88  13.43  13.88  13.43  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57311  Repair urethrovaginal lesion                      A   8.91   6.04NA   5.55NA   6.04     5.55     0.86  15.81  15.32  15.81  15.32  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57320  Repair bladder-vagina lesion                      A   8.88   6.13NA   5.79NA   6.13     5.79     1.05  16.06  15.72  16.06  15.72  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57330  Repair bladder-vagina lesion                      A  13.21   7.76NA   7.20NA   7.76     7.20     1.28  22.25  21.69  22.25  21.69  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57335  Repair vagina                                     A  20.02  11.32NA  11.72NA  11.32    11.72     3.38  34.72  35.12  34.72  35.12  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57400  Dilation of vagina                                A   2.27   1.34NA   1.37NA   1.34     1.37     0.38   3.99   4.02   3.99   4.02  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
57410  Pelvic examination                                A   1.75   1.14NA   1.19NA   1.14     1.19     0.29   3.18   3.23   3.18   3.23  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57415  Remove vaginal foreign body                       A   2.49   1.89NA   1.90NA   1.89     1.90     0.37   4.75   4.76   4.75   4.76  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
57420  Exam of vagina w/scope                            A   1.60   1.57     1.56     0.81     0.87     0.26   3.43   3.42   2.67   2.73  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57421  Exam/biopsy of vag w/scope                        A   2.20   2.05     2.05     1.08     1.16     0.37   4.62   4.62   3.65   3.73  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57423  Repair paravag defect lap                         A  16.08   8.67NA   8.96NA   8.67     8.96     2.72  27.47  27.76  27.47  27.76  0090.08.83.0920220             25.5217 090 99      0.00   0.00   0.00
57425  Laparoscopy surg colpopexy                        A  17.03   9.21NA   9.66NA   9.21     9.66     2.66  28.90  29.35  28.90  29.35  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57426  Revise prosth vag graft lap                       A  14.30   8.42NA   8.42NA   8.42     8.42     2.40  25.12  25.12  25.12  25.12  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57452  Exam of cervix w/scope                            A   1.50   1.48     1.47     0.98     1.02     0.24   3.22   3.21   2.72   2.76  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57454  Bx/curett of cervix w/scope                       A   2.33   1.84     1.87     1.34     1.41     0.38   4.55   4.58   4.05   4.12  0000.00.00.0030100       57452 25.5217 090 99      0.00   0.00   0.00
57455  Biopsy of cervix w/scope                          A   1.99   1.92     1.92     0.98     1.05     0.33   4.24   4.24   3.30   3.37  0000.00.00.0030100       57452 25.5217 090 99      0.00   0.00   0.00
57456  Endocerv curettage w/scope                        A   1.85   1.85     1.84     0.92     0.98     0.31   4.01   4.00   3.08   3.14  0000.00.00.0030100       57452 25.5217 090 99      0.00   0.00   0.00
57460  Bx of cervix w/scope leep                         A   2.83   5.32     4.91     1.56     1.64     0.48   8.63   8.22   4.87   4.95  0000.00.00.0030100       57452 25.5217 090 99      0.00   0.00   0.00
57461  Conz of cervix w/scope leep                       A   3.43   5.69     5.30     1.60     1.72     0.58   9.70   9.31   5.61   5.73  0000.00.00.0030100       57452 25.5217 090 99      0.00   0.00   0.00
57500  Biopsy of cervix                                  A   1.20   2.46     2.29     0.84     0.88     0.20   3.86   3.69   2.24   2.28  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
57505  Endocervical curettage                            A   1.19   1.63     1.59     1.33     1.33     0.20   3.02   2.98   2.72   2.72  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57510  Cauterization of cervix                           A   1.90   1.69     1.69     1.22     1.27     0.31   3.90   3.90   3.43   3.48  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57511  Cryocautery of cervix                             A   1.95   2.04     2.03     1.65     1.68     0.33   4.32   4.31   3.93   3.96  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57513  Laser surgery of cervix                           A   1.95   1.98     1.98     1.66     1.68     0.33   4.26   4.26   3.94   3.96  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57520  Conization of cervix                              A   4.11   4.29     4.23     3.30     3.35     0.68   9.08   9.02   8.09   8.14  0090.12.74.1420100             25.5217 090 99      0.00   0.00   0.00
57522  Conization of cervix                              A   3.67   3.53     3.52     2.93     2.99     0.62   7.82   7.81   7.22   7.28  0090.12.74.1420100             25.5217 090 99      0.00   0.00   0.00
57530  Removal of cervix                                 A   5.27   4.09NA   4.17NA   4.09     4.17     0.87  10.23  10.31  10.23  10.31  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57531  Removal of cervix radical                         A  29.95  15.89NA  17.28NA  15.89    17.28     5.05  50.89  52.28  50.89  52.28  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
57540  Removal of residual cervix                        A  13.29   7.65NA   8.09NA   7.65     8.09     2.23  23.17  23.61  23.17  23.61  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57545  Remove cervix/repair pelvis                       A  14.10   8.01NA   8.46NA   8.01     8.46     2.35  24.46  24.91  24.46  24.91  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57550  Removal of residual cervix                        A   6.34   4.73NA   4.84NA   4.73     4.84     1.07  12.14  12.25  12.14  12.25  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57555  Remove cervix/repair vagina                       A   9.94   6.26NA   6.55NA   6.26     6.55     1.66  17.86  18.15  17.86  18.15  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57556  Remove cervix repair bowel                        A   9.36   6.05NA   6.15NA   6.05     6.15     1.45  16.86  16.96  16.86  16.96  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
57558  D&c of cervical stump                             A   1.72   1.71     1.70     1.37     1.40     0.29   3.72   3.71   3.38   3.41  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
57700  Revision of cervix                                A   4.35   4.16NA   4.18NA   4.16     4.18     0.72   9.23   9.25   9.23   9.25  0090.12.74.1420000             25.5217 090 99      0.00   0.00   0.00
57720  Revision of cervix                                A   4.61   3.77NA   3.83NA   3.77     3.83     0.76   9.14   9.20   9.14   9.20  0090.12.74.1420200             25.5217 090 99      0.00   0.00   0.00
57800  Dilation of cervical canal                        A   0.77   0.89     0.88     0.55     0.56     0.12   1.78   1.77   1.44   1.45  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
58100  Biopsy of uterus lining                           A   1.53   1.47     1.46     0.83     0.88     0.26   3.26   3.25   2.62   2.67  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
58110  Bx done w/colposcopy add-on                       A   0.77   0.54     0.55     0.33     0.36     0.12   1.43   1.44   1.22   1.25  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
58120  Dilation and curettage                            A   3.59   3.34     3.44     2.26     2.37     0.61   7.54   7.64   6.46   6.57  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
58140  Myomectomy abdom method                           A  15.79   8.70NA   9.28NA   8.70     9.28     2.80  27.29  27.87  27.29  27.87  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58145  Myomectomy vag method                             A   8.91   5.76NA   6.00NA   5.76     6.00     1.49  16.16  16.40  16.16  16.40  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58146  Myomectomy abdom complex                          A  20.34  10.66NA  11.30NA  10.66    11.30     3.44  34.44  35.08  34.44  35.08  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58150  Total hysterectomy                                A  17.31   9.31NA   9.97NA   9.31     9.97     2.93  29.55  30.21  29.55  30.21  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58152  Total hysterectomy                                A  21.86  11.51NA  12.25NA  11.51    12.25     3.73  37.10  37.84  37.10  37.84  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58180  Partial hysterectomy                              A  16.60   9.02NA   9.60NA   9.02     9.60     2.80  28.42  29.00  28.42  29.00  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58200  Extensive hysterectomy                            A  23.10  11.97NA  12.91NA  11.97    12.91     3.88  38.95  39.89  38.95  39.89  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58210  Extensive hysterectomy                            A  30.91  15.89NA  17.23NA  15.89    17.23     5.26  52.06  53.40  52.06  53.40  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58240  Removal of pelvis contents                        A  49.33  24.96NA  26.97NA  24.96    26.97     8.31  82.60  84.61  82.60  84.61  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58260  Vaginal hysterectomy                              A  14.15   8.08NA   8.53NA   8.08     8.53     2.38  24.61  25.06  24.61  25.06  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58262  Vag hyst including t/o                            A  15.94   8.83NA   9.34NA   8.83     9.34     2.69  27.46  27.97  27.46  27.97  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58263  Vag hyst w/t/o & vag repair                       A  17.23   9.40NA   9.94NA   9.40     9.94     2.91  29.54  30.08  29.54  30.08  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58267  Vag hyst w/urinary repair                         A  18.36   9.94NA  10.54NA   9.94    10.54     3.11  31.41  32.01  31.41  32.01  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58270  Vag hyst w/enterocele repair                      A  15.30   8.38NA   8.86NA   8.38     8.86     2.57  26.25  26.73  26.25  26.73  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58275  Hysterectomy/revise vagina                        A  17.03   9.36NA   9.90NA   9.36     9.90     2.89  29.28  29.82  29.28  29.82  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58280  Hysterectomy/revise vagina                        A  18.33   9.92NA  10.54NA   9.92    10.54     3.07  31.32  31.94  31.32  31.94  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58285  Extensive hysterectomy                            A  23.38  11.78NA  12.58NA  11.78    12.58     3.92  39.08  39.88  39.08  39.88  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58290  Vag hyst complex                                  A  20.27  10.61NA  11.27NA  10.61    11.27     3.42  34.30  34.96  34.30  34.96  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58291  Vag hyst incl t/o complex                         A  22.06  11.43NA  12.11NA  11.43    12.11     3.72  37.21  37.89  37.21  37.89  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58292  Vag hyst t/o & repair compl                       A  23.35  11.94NA  12.70NA  11.94    12.70     3.92  39.21  39.97  39.21  39.97  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58293  Vag hyst w/uro repair compl                       A  24.33  12.32NA  13.16NA  12.32    13.16     4.10  40.75  41.59  40.75  41.59  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58294  Vag hyst w/enterocele compl                       A  21.55  11.11NA  11.86NA  11.11    11.86     3.65  36.31  37.06  36.31  37.06  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58300  Insert intrauterine device                        N+  1.01   1.05     0.94     0.44     0.44     0.07   2.13   2.02   1.52   1.52  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
58301  Remove intrauterine device                        A   1.27   1.35     1.33     0.54     0.59     0.22   2.84   2.82   2.03   2.08  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
58321  Artificial insemination                           A   0.92   1.24     1.18     0.40     0.42     0.05   2.21   2.15   1.37   1.39  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
58322  Artificial insemination                           A   1.10   1.29     1.25     0.47     0.51     0.18   2.57   2.53   1.75   1.79  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
58323  Sperm washing                                     A   0.23   0.25     0.19     0.10     0.11     0.04   0.52   0.46   0.37   0.38  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
58340  Catheter for hysterography                        A   0.88   2.63     2.34     0.73     0.72     0.12   3.63   3.34   1.73   1.72  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
58345  Reopen fallopian tube                             A   4.70   2.86NA   2.96NA   2.86     2.96     0.77   8.33   8.43   8.33   8.43  0010.10.80.1021220             25.5217 090 99      0.00   0.00   0.00
58346  Insert heyman uteri capsule                       A   7.56   4.77NA   4.77NA   4.77     4.77     0.62  12.95  12.95  12.95  12.95  0090.12.74.1420100             25.5217 090 99      0.00   0.00   0.00
58350  Reopen fallopian tube                             A   1.06   1.64     1.58     1.10     1.10     0.18   2.88   2.82   2.34   2.34  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
58353  Endometr ablate thermal                           A   3.60  27.71    23.90     2.34     2.41     0.61  31.92  28.11   6.55   6.62  0010.10.80.1020120             25.5217 090 99      0.00   0.00   0.00
58356  Endometrial cryoablation                          A   6.41  51.65    45.31     2.87     3.07     1.07  59.13  52.79  10.35  10.55  0010.10.80.1020220             25.5217 090 99      0.00   0.00   0.00
58400  Suspension of uterus                              A   7.14   4.92NA   4.95NA   4.92     4.95     1.07  13.13  13.16  13.13  13.16  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58410  Suspension of uterus                              A  13.80   7.80NA   8.26NA   7.80     8.26     2.31  23.91  24.37  23.91  24.37  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58520  Repair of ruptured uterus                         A  13.48   7.62NA   8.11NA   7.62     8.11     2.89  23.99  24.48  23.99  24.48  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58540  Revision of uterus                                A  15.71   8.66NA   9.21NA   8.66     9.21     2.65  27.02  27.57  27.02  27.57  0090.12.74.1420200             25.5217 090 99      0.00   0.00   0.00
58541  Lsh uterus 250 g or less                          A  14.70   8.43NA   9.01NA   8.43     9.01     2.46  25.59  26.17  25.59  26.17  0090.12.74.1430220       49320 25.5217 090 99      0.00   0.00   0.00
58542  Lsh w/t/o ut 250 g or less                        A  16.56   9.22NA   9.88NA   9.22     9.88     2.80  28.58  29.24  28.58  29.24  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58543  Lsh uterus above 250 g                            A  16.87   9.34NA  10.04NA   9.34    10.04     2.85  29.06  29.76  29.06  29.76  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58544  Lsh w/t/o uterus above 250 g                      A  18.37   9.93NA  10.73NA   9.93    10.73     3.11  31.41  32.21  31.41  32.21  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58545  Laparoscopic myomectomy                           A  15.55   8.40NA   8.93NA   8.40     8.93     2.66  26.61  27.14  26.61  27.14  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58546  Laparo-myomectomy complex                         A  19.94  10.27NA  10.93NA  10.27    10.93     3.38  33.59  34.25  33.59  34.25  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58548  Lap radical hyst                                  A  31.63  16.16NA  17.88NA  16.16    17.88     5.31  53.10  54.82  53.10  54.82  0090.12.74.1422220             25.5217 090 99      0.00   0.00   0.00
58550  Laparo-asst vag hysterectomy                      A  15.10   8.62NA   9.09NA   8.62     9.09     2.55  26.27  26.74  26.27  26.74  0090.12.74.1430220       49320 25.5217 090 99      0.00   0.00   0.00
58552  Laparo-vag hyst incl t/o                          A  16.91   9.37NA   9.92NA   9.37     9.92     2.87  29.15  29.70  29.15  29.70  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58553  Laparo-vag hyst complex                           A  20.06  10.34NA  11.04NA  10.34    11.04     3.40  33.80  34.50  33.80  34.50  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58554  Laparo-vag hyst w/t/o compl                       A  23.11  12.06NA  12.90NA  12.06    12.90     3.92  39.09  39.93  39.09  39.93  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58555  Hysteroscopy dx sep proc                          A   3.33   4.12     4.97     1.77     1.88     0.56   8.01   8.86   5.66   5.77  0000.00.00.0020020             25.5217 090 99      0.00   0.00   0.00
58558  Hysteroscopy biopsy                               A   4.74   5.08     6.09     2.42     2.56     0.80  10.62  11.63   7.96   8.10  0000.00.00.0030120       58555 25.5217 090 99      0.00   0.00   0.00
58559  Hysteroscopy lysis                                A   6.16   3.03NA   3.22NA   3.03     3.22     1.05  10.24  10.43  10.24  10.43  0000.00.00.0030120       58555 25.5217 090 99      0.00   0.00   0.00
58560  Hysteroscopy resect septum                        A   6.99   3.40NA   3.61NA   3.40     3.61     1.18  11.57  11.78  11.57  11.78  0000.00.00.0030220       58555 25.5217 090 99      0.00   0.00   0.00
58561  Hysteroscopy remove myoma                         A   9.99   4.69NA   5.01NA   4.69     5.01     1.67  16.35  16.67  16.35  16.67  0000.00.00.0030020       58555 25.5217 090 99      0.00   0.00   0.00
58562  Hysteroscopy remove fb                            A   5.20   5.04     6.02     2.59     2.74     0.87  11.11  12.09   8.66   8.81  0000.00.00.0030120       58555 25.5217 090 99      0.00   0.00   0.00
58563  Hysteroscopy ablation                             A   6.16  45.03    39.21     3.04     3.22     1.05  52.24  46.42  10.25  10.43  0000.00.00.0030020       58555 25.5217 090 99      0.00   0.00   0.00
58565  Hysteroscopy sterilization                        A   7.12  48.55    43.93     4.60     4.77     1.20  56.87  52.25  12.92  13.09  0090.12.74.1432120       58555 25.5217 090 99      0.00   0.00   0.00
58570  Tlh uterus 250 g or less                          A  15.88   8.94NA   9.60NA   8.94     9.60     2.69  27.51  28.17  27.51  28.17  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58571  Tlh w/t/o 250 g or less                           A  17.69   9.77NA  10.61NA   9.77    10.61     3.00  30.46  31.30  30.46  31.30  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58572  Tlh uterus over 250 g                             A  20.09  10.69NA  11.60NA  10.69    11.60     3.40  34.18  35.09  34.18  35.09  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58573  Tlh w/t/o uterus over 250 g                       A  23.11  12.02NA  13.16NA  12.02    13.16     3.88  39.01  40.15  39.01  40.15  0090.12.74.1420220             25.5217 090 99      0.00   0.00   0.00
58578  Laparo proc uterus                                C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
58579  Hysteroscope procedure                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
58600  Division of fallopian tube                        A   5.91   3.92NA   4.09NA   3.92     4.09     1.00  10.83  11.00  10.83  11.00  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58605  Division of fallopian tube                        A   5.28   3.63NA   3.75NA   3.63     3.75     0.88   9.79   9.91   9.79   9.91  0090.12.74.1422200             25.5217 090 99      0.00   0.00   0.00
58611  Ligate oviduct(s) add-on                          A   1.45   0.62NA   0.68NA   0.62     0.68     0.24   2.31   2.37   2.31   2.37  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
58615  Occlude fallopian tube(s)                         A   3.94   2.73NA   2.75NA   2.73     2.75     0.67   7.34   7.36   7.34   7.36  0010.10.80.1020200             25.5217 090 99      0.00   0.00   0.00
58660  Laparoscopy lysis                                 A  11.59   6.36NA   6.76NA   6.36     6.76     2.04  19.99  20.39  19.99  20.39  0090.09.84.0730220       49320 25.5217 090 99      0.00   0.00   0.00
58661  Laparoscopy remove adnexa                         A  11.35   5.85NA   6.23NA   5.85     6.23     1.93  19.13  19.51  19.13  19.51  0010.10.80.1031220       49320 25.5217 090 99      0.00   0.00   0.00
58662  Laparoscopy excise lesions                        A  12.15   6.75NA   7.13NA   6.75     7.13     2.06  20.96  21.34  20.96  21.34  0090.09.84.0730220       49320 25.5217 090 99      0.00   0.00   0.00
58670  Laparoscopy tubal cautery                         A   5.91   3.96NA   4.11NA   3.96     4.11     1.00  10.87  11.02  10.87  11.02  0090.10.80.1030120       49320 25.5217 090 99      0.00   0.00   0.00
58671  Laparoscopy tubal block                           A   5.91   3.95NA   4.10NA   3.95     4.10     1.00  10.86  11.01  10.86  11.01  0090.10.80.1030120       49320 25.5217 090 99      0.00   0.00   0.00
58672  Laparoscopy fimbrioplasty                         A  12.91   6.84NA   7.26NA   6.84     7.26     2.17  21.92  22.34  21.92  22.34  0090.10.80.1031200       49320 25.5217 090 99      0.00   0.00   0.00
58673  Laparoscopy salpingostomy                         A  14.04   7.46NA   7.89NA   7.46     7.89     2.35  23.85  24.28  23.85  24.28  0090.10.80.1031200       49320 25.5217 090 99      0.00   0.00   0.00
58679  Laparo proc oviduct-ovary                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
58700  Removal of fallopian tube                         A  12.95   7.61NA   8.13NA   7.61     8.13     2.40  22.96  23.48  22.96  23.48  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58720  Removal of ovary/tube(s)                          A  12.16   7.11NA   7.53NA   7.11     7.53     2.15  21.42  21.84  21.42  21.84  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58740  Adhesiolysis tube ovary                           A  14.90   8.49NA   8.94NA   8.49     8.94     2.63  26.02  26.47  26.02  26.47  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58750  Repair oviduct                                    A  15.64   8.60NA   9.08NA   8.60     9.08     2.63  26.87  27.35  26.87  27.35  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58752  Revise ovarian tube(s)                            A  15.64   8.60NA   8.85NA   8.60     8.85     1.10  25.34  25.59  25.34  25.59  0090.12.74.1420200             25.5217 090 99      0.00   0.00   0.00
58760  Fimbrioplasty                                     A  13.93   7.91NA   8.28NA   7.91     8.28     2.34  24.18  24.55  24.18  24.55  0090.12.74.1421210             25.5217 090 99      0.00   0.00   0.00
58770  Create new tubal opening                          A  14.77   7.91NA   8.61NA   7.91     8.61     2.47  25.15  25.85  25.15  25.85  0090.12.74.1421200             25.5217 090 99      0.00   0.00   0.00
58800  Drainage of ovarian cyst(s)                       A   4.62   4.14     4.09     3.52     3.57     0.76   9.52   9.47   8.90   8.95  0090.12.74.1422100             25.5217 090 99      0.00   0.00   0.00
58805  Drainage of ovarian cyst(s)                       A   6.42   4.48NA   4.54NA   4.48     4.54     1.09  11.99  12.05  11.99  12.05  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58820  Drain ovary abscess open                          A   4.70   4.21NA   4.62NA   4.21     4.62     0.77   9.68  10.09   9.68  10.09  0090.12.74.1420200             25.5217 090 99      0.00   0.00   0.00
58822  Drain ovary abscess percut                        A  11.81   7.17NA   7.39NA   7.17     7.39     2.51  21.49  21.71  21.49  21.71  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58823  Drain pelvic abscess percut                       A   3.37  23.22    21.62     1.40     1.27     0.38  26.97  25.37   5.15   5.02  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
58825  Transposition ovary(s)                            A  11.78   7.08NA   7.59NA   7.08     7.59     1.97  20.83  21.34  20.83  21.34  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58900  Biopsy of ovary(s)                                A   6.59   4.97NA   5.45NA   4.97     5.45     1.40  12.96  13.44  12.96  13.44  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58920  Partial removal of ovary(s)                       A  11.95   6.84NA   7.26NA   6.84     7.26     2.00  20.79  21.21  20.79  21.21  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58925  Removal of ovarian cyst(s)                        A  12.43   7.28NA   7.74NA   7.28     7.74     2.23  21.94  22.40  21.94  22.40  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58940  Removal of ovary(s)                               A   8.22   5.49NA   5.87NA   5.49     5.87     1.53  15.24  15.62  15.24  15.62  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58943  Removal of ovary(s)                               A  19.52  10.44NA  11.24NA  10.44    11.24     3.52  33.48  34.28  33.48  34.28  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58950  Resect ovarian malignancy                         A  18.37  10.37NA  11.13NA  10.37    11.13     3.25  31.99  32.75  31.99  32.75  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58951  Resect ovarian malignancy                         A  24.26  12.66NA  13.70NA  12.66    13.70     4.17  41.09  42.13  41.09  42.13  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58952  Resect ovarian malignancy                         A  27.29  14.35NA  15.53NA  14.35    15.53     4.73  46.37  47.55  46.37  47.55  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58953  Tah rad dissect for debulk                        A  34.13  17.38NA  18.85NA  17.38    18.85     5.87  57.38  58.85  57.38  58.85  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58954  Tah rad debulk/lymph remove                       A  37.13  18.71NA  20.28NA  18.71    20.28     6.34  62.18  63.75  62.18  63.75  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58956  Bso omentectomy w/tah                             A  22.80  12.43NA  13.35NA  12.43    13.35     3.98  39.21  40.13  39.21  40.13  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58957  Resect recurrent gyn mal                          A  26.22  13.71NA  15.06NA  13.71    15.06     4.79  44.72  46.07  44.72  46.07  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58958  Resect recur gyn mal w/lym                        A  29.22  15.01NA  16.42NA  15.01    16.42     4.93  49.16  50.57  49.16  50.57  0090.12.74.1422210             25.5217 090 99      0.00   0.00   0.00
58960  Exploration of abdomen                            A  15.79   8.96NA   9.54NA   8.96     9.54     2.76  27.51  28.09  27.51  28.09  0090.12.74.1420210             25.5217 090 99      0.00   0.00   0.00
58970  Retrieval of oocyte                               A   3.52   2.52     2.58     1.84     1.99     0.26   6.30   6.36   5.62   5.77  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
58974  Transfer of embryo                                C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0000.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
58976  Transfer of embryo                                A   3.82   3.05     3.01     2.07     2.08     0.27   7.14   7.10   6.16   6.17  0000.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
58999  Genital surgery procedure                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020111             25.5217 090 99      0.00   0.00   0.00
59000  Amniocentesis diagnostic                          A   1.30   2.13     2.01     0.76     0.79     0.37   3.80   3.68   2.43   2.46  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59001  Amniocentesis therapeutic                         A   3.00   1.63NA   1.64NA   1.63     1.64     0.86   5.49   5.50   5.49   5.50  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59012  Fetal cord puncture prenatal                      A   3.44   1.69NA   1.80NA   1.69     1.80     0.99   6.12   6.23   6.12   6.23  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59015  Chorion biopsy                                    A   2.20   1.84     1.86     1.16     1.22     0.62   4.66   4.68   3.98   4.04  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59020  Fetal contract stress test                        A   0.66   1.22     1.23     1.22NA   1.23 NA  0.17   2.05   2.06   2.05   2.06  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
59020TCFetal contract stress test                        A   0.00   0.94     0.92     0.94NA   0.92 NA  0.01   0.95   0.93   0.95   0.93  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
5902026Fetal contract stress test                        A   0.66   0.28     0.31     0.28     0.31     0.16   1.10   1.13   1.10   1.13  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
59025  Fetal non-stress test                             A   0.53   0.73     0.75     0.73NA   0.75 NA  0.13   1.39   1.41   1.39   1.41  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
59025TCFetal non-stress test                             A   0.00   0.50     0.50     0.50NA   0.50 NA  0.01   0.51   0.51   0.51   0.51  1000.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
5902526Fetal non-stress test                             A   0.53   0.23     0.25     0.23     0.25     0.12   0.88   0.90   0.88   0.90  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
59030  Fetal scalp blood sample                          A   1.99   0.83NA   0.88NA   0.83     0.88     0.12   2.94   2.99   2.94   2.99  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59050  Fetal monitor w/report                            A   0.89   0.38NA   0.42NA   0.38     0.42     0.26   1.53   1.57   1.53   1.57  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
59051  Fetal monitor/interpret only                      A   0.74   0.31NA   0.35NA   0.31     0.35     0.22   1.27   1.31   1.27   1.31  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
59070  Transabdom amnioinfus w/us                        A   5.24   5.82     5.75     2.65     2.71     1.51  12.57  12.50   9.40   9.46  0000.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
59072  Umbilical cord occlud w/us                        A   8.99   4.22NA   4.36NA   4.22     4.36     2.58  15.79  15.93  15.79  15.93  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59074  Fetal fluid drainage w/us                         A   5.24   5.58     5.92     2.76     3.01     1.51  12.33  12.67   9.51   9.76  0000.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
59076  Fetal shunt placement w/us                        A   8.99   4.05NA   4.36NA   4.05     4.36     2.58  15.62  15.93  15.62  15.93  0000.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
59100  Remove uterus lesion                              A  13.37   7.73NA   8.21NA   7.73     8.21     3.83  24.93  25.41  24.93  25.41  0090.17.60.2320210             25.5217 090 99      0.00   0.00   0.00
59120  Treat ectopic pregnancy                           A  12.67   7.51NA   7.89NA   7.51     7.89     3.65  23.83  24.21  23.83  24.21  0090.17.60.2320210             25.5217 090 99      0.00   0.00   0.00
59121  Treat ectopic pregnancy                           A  12.74   7.46NA   7.83NA   7.46     7.83     3.67  23.87  24.24  23.87  24.24  0090.17.60.2320210             25.5217 090 99      0.00   0.00   0.00
59130  Treat ectopic pregnancy                           A  15.08   8.40NA   8.92NA   8.40     8.92     1.07  24.55  25.07  24.55  25.07  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59135  Treat ectopic pregnancy                           A  14.92   8.58NA   8.65NA   8.58     8.65     1.06  24.56  24.63  24.56  24.63  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59136  Treat ectopic pregnancy                           A  14.25   8.00NA   8.47NA   8.00     8.47     4.09  26.34  26.81  26.34  26.81  0090.17.60.2320200             25.5217 090 99      0.00   0.00   0.00
59140  Treat ectopic pregnancy                           A   5.94   4.28NA   4.48NA   4.28     4.48     0.41  10.63  10.83  10.63  10.83  0090.17.60.2320200             25.5217 090 99      0.00   0.00   0.00
59150  Treat ectopic pregnancy                           A  12.29   7.24NA   7.62NA   7.24     7.62     3.53  23.06  23.44  23.06  23.44  0090.17.60.2320200             25.5217 090 99      0.00   0.00   0.00
59151  Treat ectopic pregnancy                           A  12.11   6.90NA   7.25NA   6.90     7.25     3.48  22.49  22.84  22.49  22.84  0090.17.60.2320200             25.5217 090 99      0.00   0.00   0.00
59160  D & c after delivery                              A   2.76   2.72     2.57     1.76     1.73     0.77   6.25   6.10   5.29   5.26  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
59200  Insert cervical dilator                           A   0.79   1.17     1.11     0.34     0.37     0.23   2.19   2.13   1.36   1.39  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59300  Episiotomy or vaginal repair                      A   2.41   2.65     2.65     1.33     1.44     0.68   5.74   5.74   4.42   4.53  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59320  Revision of cervix                                A   2.48   1.41NA   1.48NA   1.41     1.48     0.69   4.58   4.65   4.58   4.65  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59325  Revision of cervix                                A   4.06   2.09NA   2.21NA   2.09     2.21     0.29   6.44   6.56   6.44   6.56  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59350  Repair of uterus                                  A   4.94   2.05NA   2.31NA   2.05     2.31     1.41   8.40   8.66   8.40   8.66  0000.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
59400  Obstetrical care                                  A  28.69  19.40NA  20.68NA  19.40    20.68     7.97  56.06  57.34  56.06  57.34  0MMM.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59409  Obstetrical care                                  A  12.82   5.65NA   6.02NA   5.65     6.02     3.54  22.01  22.38  22.01  22.38  0MMM.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59410  Obstetrical care                                  A  16.07   7.40NA   8.03NA   7.40     8.03     4.44  27.91  28.54  27.91  28.54  0MMM.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59412  Antepartum manipulation                           A   1.53   0.87NA   0.88NA   0.87     0.88     0.43   2.83   2.84   2.83   2.84  0MMM.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
59414  Deliver placenta                                  A   1.44   0.65NA   0.67NA   0.65     0.67     0.45   2.54   2.56   2.54   2.56  0MMM.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59425  Antepartum care only                              A   5.63   5.31     5.34     2.43     2.62     1.55  12.49  12.52   9.61   9.80  0MMM.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
59426  Antepartum care only                              A   9.96   9.67     9.73     4.30     4.64     2.69  22.32  22.38  16.95  17.29  0MMM.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
59430  Care after delivery                               A   2.20   1.84     2.27     1.00     1.03     0.60   4.64   5.07   3.80   3.83  0MMM.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59510  Cesarean delivery                                 A  31.80  21.59NA  22.68NA  21.59    22.68     9.04  62.43  63.52  62.43  63.52  0MMM.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59514  Cesarean delivery only                            A  14.39   6.53NA   6.77NA   6.53     6.77     4.07  24.99  25.23  24.99  25.23  0MMM.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
59515  Cesarean delivery                                 A  19.15   9.25NA  10.07NA   9.25    10.07     5.42  33.82  34.64  33.82  34.64  0MMM.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59525  Remove uterus after cesarean                      A   8.53   3.67NA   3.98NA   3.67     3.98     2.43  14.63  14.94  14.63  14.94  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
59610  Vbac delivery                                     A  30.22  20.17NA  21.32NA  20.17    21.32     8.68  59.07  60.22  59.07  60.22  0MMM.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59612  Vbac delivery only                                A  14.35   6.35NA   6.70NA   6.35     6.70     4.11  24.81  25.16  24.81  25.16  0MMM.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59614  Vbac care after delivery                          A  17.60   7.92NA   8.66NA   7.92     8.66     5.04  30.56  31.30  30.56  31.30  0MMM.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59618  Attempted vbac delivery                           A  32.26  22.08NA  22.83NA  22.08    22.83     9.26  63.60  64.35  63.60  64.35  0MMM.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59620  Attempted vbac delivery only                      A  14.86   6.92NA   6.93NA   6.92     6.93     4.26  26.04  26.05  26.04  26.05  0MMM.00.00.0020200             25.5217 090 99      0.00   0.00   0.00
59622  Attempted vbac after care                         A  19.63   9.78NA  10.32NA   9.78    10.32     5.64  35.05  35.59  35.05  35.59  0MMM.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59812  Treatment of miscarriage                          A   4.44   3.78     3.86     3.13     3.25     1.25   9.47   9.55   8.82   8.94  0090.17.60.2320100             25.5217 090 99      0.00   0.00   0.00
59820  Care of miscarriage                               A   4.84   5.12     5.08     4.40     4.47     1.39  11.35  11.31  10.63  10.70  0090.17.60.2320100             25.5217 090 99      0.00   0.00   0.00
59821  Treatment of miscarriage                          A   5.09   4.89     4.88     4.12     4.21     1.47  11.45  11.44  10.68  10.77  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59830  Treat uterus infection                            A   6.59   4.61NA   4.74NA   4.61     4.74     1.89  13.09  13.22  13.09  13.22  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59840  Abortion                                          R   3.01   2.61     2.67     2.38     2.42     0.80   6.42   6.48   6.19   6.23  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
59841  Abortion                                          R   5.65   4.15     4.28     3.52     3.69     1.62  11.42  11.55  10.79  10.96  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
59850  Abortion                                          R   5.90   3.95NA   3.96NA   3.95     3.96     0.41  10.26  10.27  10.26  10.27  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59851  Abortion                                          R   5.92   4.34NA   4.44NA   4.34     4.44     1.68  11.94  12.04  11.94  12.04  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59852  Abortion                                          R   8.23   6.03NA   6.02NA   6.03     6.02     0.58  14.84  14.83  14.84  14.83  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59855  Abortion                                          R   6.43   4.18NA   4.33NA   4.18     4.33     1.85  12.46  12.61  12.46  12.61  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59856  Abortion                                          R   7.79   4.63NA   4.83NA   4.63     4.83     2.23  14.65  14.85  14.65  14.85  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59857  Abortion                                          R   9.33   5.40NA   5.44NA   5.40     5.44     0.65  15.38  15.42  15.38  15.42  0090.17.60.2320000             25.5217 090 99      0.00   0.00   0.00
59866  Abortion (mpr)                                    R   3.99   2.08NA   2.16NA   2.08     2.16     0.29   6.36   6.44   6.36   6.44  0000.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
59870  Evacuate mole of uterus                           A   6.57   5.71NA   5.73NA   5.71     5.73     1.89  14.17  14.19  14.17  14.19  0090.17.60.2320200             25.5217 090 99      0.00   0.00   0.00
59871  Remove cerclage suture                            A   2.13   1.29NA   1.34NA   1.29     1.34     0.61   4.03   4.08   4.03   4.08  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
59897  Fetal invas px w/us                               C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
59898  Laparo proc ob care/deliver                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
59899  Maternity care procedure                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
60000  Drain thyroid/tongue cyst                         A   1.81   2.74     2.86     2.28     2.37     0.24   4.79   4.91   4.33   4.42  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
6005F  Care level rationale doc                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
6010F  Dysphag test done b/4 eating                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
60100  Biopsy of thyroid                                 A   1.56   1.58     1.48     0.65     0.61     0.16   3.30   3.20   2.37   2.33  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
6015F  Dysphag test done b/4 eating                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
6020F  Npo (nothing-mouth) ordered                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
60200  Remove thyroid lesion                             A  10.02   7.67NA   8.26NA   7.67     8.26     1.70  19.39  19.98  19.39  19.98  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60210  Partial thyroid excision                          A  11.23   7.45NA   8.14NA   7.45     8.14     2.06  20.74  21.43  20.74  21.43  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60212  Partial thyroid excision                          A  16.43  10.31NA  11.42NA  10.31    11.42     3.06  29.80  30.91  29.80  30.91  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60220  Partial removal of thyroid                        A  12.37   8.14NA   8.91NA   8.14     8.91     2.15  22.66  23.43  22.66  23.43  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60225  Partial removal of thyroid                        A  14.79   9.83NA  10.72NA   9.83    10.72     2.63  27.25  28.14  27.25  28.14  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60240  Removal of thyroid                                A  16.22   9.44NA  10.32NA   9.44    10.32     2.95  28.61  29.49  28.61  29.49  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60252  Removal of thyroid                                A  22.01  12.92NA  14.15NA  12.92    14.15     3.87  38.80  40.03  38.80  40.03  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60254  Extensive thyroid surgery                         A  28.42  16.84NA  18.44NA  16.84    18.44     4.52  49.78  51.38  49.78  51.38  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60260  Repeat thyroid surgery                            A  18.26  10.89NA  11.93NA  10.89    11.93     3.12  32.27  33.31  32.27  33.31  0090.09.82.0921210             25.5217 090 99      0.00   0.00   0.00
60270  Removal of thyroid                                A  23.20  13.17NA  14.04NA  13.17    14.04     4.37  40.74  41.61  40.74  41.61  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60271  Removal of thyroid                                A  17.62  10.55NA  11.44NA  10.55    11.44     3.00  31.17  32.06  31.17  32.06  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60280  Remove thyroid duct lesion                        A   6.16   6.09NA   6.53NA   6.09     6.53     0.84  13.09  13.53  13.09  13.53  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60281  Remove thyroid duct lesion                        A   8.82   7.49NA   8.22NA   7.49     8.22     1.14  17.45  18.18  17.45  18.18  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
6030F  Max sterile barriers follwd                       M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
60300  Aspir/inj thyroid cyst                            A   0.97   2.19     2.18     0.39     0.38     0.11   3.27   3.26   1.47   1.46  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
6040F  Appro rad ds dvcs techs docd                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
6045F  Radxps in end rprt4fluro pxd                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
60500  Explore parathyroid glands                        A  16.78   9.87NA  10.83NA   9.87    10.83     3.23  29.88  30.84  29.88  30.84  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60502  Re-explore parathyroids                           A  21.15  12.25NA  13.42NA  12.25    13.42     4.14  37.54  38.71  37.54  38.71  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60505  Explore parathyroid glands                        A  23.06  13.62NA  14.75NA  13.62    14.75     4.32  41.00  42.13  41.00  42.13  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60512  Autotransplant parathyroid                        A   4.44   1.90NA   2.10NA   1.90     2.10     0.83   7.17   7.37   7.17   7.37  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
60520  Removal of thymus gland                           A  17.16   9.88NA  10.54NA   9.88    10.54     3.46  30.50  31.16  30.50  31.16  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60521  Removal of thymus gland                           A  19.18  10.66NA  10.41NA  10.66    10.41     4.52  34.36  34.11  34.36  34.11  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60522  Removal of thymus gland                           A  23.48  12.70NA  12.52NA  12.70    12.52     5.45  41.63  41.45  41.63  41.45  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60540  Explore adrenal gland                             A  18.02  10.26NA  10.23NA  10.26    10.23     3.03  31.31  31.28  31.31  31.28  0090.09.82.0921210             25.5217 090 99      0.00   0.00   0.00
60545  Explore adrenal gland                             A  20.93  11.35NA  11.61NA  11.35    11.61     3.68  35.96  36.22  35.96  36.22  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60600  Remove carotid body lesion                        A  25.09  12.50NA  12.93NA  12.50    12.93     5.30  42.89  43.32  42.89  43.32  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60605  Remove carotid body lesion                        A  31.96  16.84NA  18.79NA  16.84    18.79     4.10  52.90  54.85  52.90  54.85  0090.09.82.0920210             25.5217 090 99      0.00   0.00   0.00
60650  Laparoscopy adrenalectomy                         A  20.73  10.74NA  11.14NA  10.74    11.14     3.73  35.20  35.60  35.20  35.60  0090.09.84.0721210             25.5217 090 99      0.00   0.00   0.00
60659  Laparo proc endocrine                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
60699  Endocrine surgery procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020211             25.5217 090 99      0.00   0.00   0.00
6070F  Pt asked/cnsld aed effects                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
6080F  Pt/caregiver queried falls                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
6090F  Pt/caregiver counsel safety                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
61000  Remove cranial cavity fluid                       A   1.58   1.46NA   1.53NA   1.46     1.53     0.14   3.18   3.25   3.18   3.25  0000.00.00.0022100             25.5217 090 99      0.00   0.00   0.00
61001  Remove cranial cavity fluid                       A   1.49   1.36NA   1.32NA   1.36     1.32     0.53   3.38   3.34   3.38   3.34  0000.00.00.0022100             25.5217 090 99      0.00   0.00   0.00
61020  Remove brain cavity fluid                         A   1.51   1.99NA   2.09NA   1.99     2.09     0.50   4.00   4.10   4.00   4.10  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
61026  Injection into brain canal                        A   1.69   1.68NA   1.70NA   1.68     1.70     0.38   3.75   3.77   3.75   3.77  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
61050  Remove brain canal fluid                          A   1.51   1.43NA   1.38NA   1.43     1.38     0.12   3.06   3.01   3.06   3.01  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
61055  Injection into brain canal                        A   2.10   1.62NA   1.55NA   1.62     1.55     0.29   4.01   3.94   4.01   3.94  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
61070  Brain canal shunt procedure                       A   0.89   1.36NA   1.39NA   1.36     1.39     0.20   2.45   2.48   2.45   2.48  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
61105  Twist drill hole                                  A   5.45   5.91NA   6.33NA   5.91     6.33     1.91  13.27  13.69  13.27  13.69  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
61107  Drill skull for implantation                      A   4.99   2.67NA   2.77NA   2.67     2.77     1.78   9.44   9.54   9.44   9.54  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
61108  Drill skull for drainage                          A  11.64  10.56NA  11.22NA  10.56    11.22     4.13  26.33  26.99  26.33  26.99  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
61120  Burr hole for puncture                            A   9.60   8.63NA   9.20NA   8.63     9.20     3.45  21.68  22.25  21.68  22.25  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
61140  Pierce skull for biopsy                           A  17.23  13.53NA  14.22NA  13.53    14.22     6.10  36.86  37.55  36.86  37.55  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
61150  Pierce skull for drainage                         A  18.90  14.04NA  14.88NA  14.04    14.88     6.76  39.70  40.54  39.70  40.54  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
61151  Pierce skull for drainage                         A  13.49  10.64NA  11.38NA  10.64    11.38     4.83  28.96  29.70  28.96  29.70  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
61154  Pierce skull & remove clot                        A  17.07  13.86NA  14.64NA  13.86    14.64     6.08  37.01  37.79  37.01  37.79  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
61156  Pierce skull for drainage                         A  17.45  12.93NA  13.49NA  12.93    13.49     6.25  36.63  37.19  36.63  37.19  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61210  Pierce skull implant device                       A   5.83   3.12NA   3.23NA   3.12     3.23     2.08  11.03  11.14  11.03  11.14  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
61215  Insert brain-fluid device                         A   5.85   6.62NA   7.00NA   6.62     7.00     2.06  14.53  14.91  14.53  14.91  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
61250  Pierce skull & explore                            A  11.49   9.55NA  10.26NA   9.55    10.26     4.11  25.15  25.86  25.15  25.86  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
61253  Pierce skull & explore                            A  13.49   9.60NA  10.18NA   9.60    10.18     1.71  24.80  25.38  24.80  25.38  0090.11.76.1322200             25.5217 090 99      0.00   0.00   0.00
61304  Open skull for exploration                        A  23.41  16.70NA  17.59NA  16.70    17.59     8.13  48.24  49.13  48.24  49.13  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61305  Open skull for exploration                        A  28.64  20.23NA  21.34NA  20.23    21.34    10.25  59.12  60.23  59.12  60.23  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61312  Open skull for drainage                           A  30.17  20.27NA  21.35NA  20.27    21.35    10.77  61.21  62.29  61.21  62.29  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61313  Open skull for drainage                           A  28.09  20.13NA  21.22NA  20.13    21.22    10.01  58.23  59.32  58.23  59.32  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61314  Open skull for drainage                           A  25.90  18.51NA  19.54NA  18.51    19.54     9.25  53.66  54.69  53.66  54.69  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61315  Open skull for drainage                           A  29.65  20.64NA  21.63NA  20.64    21.63    10.63  60.92  61.91  60.92  61.91  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61316  Implt cran bone flap to abdo                      A   1.39   0.73NA   0.77NA   0.73     0.77     0.49   2.61   2.65   2.61   2.65  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
61320  Open skull for drainage                           A  27.42  18.97NA  19.80NA  18.97    19.80     9.67  56.06  56.89  56.06  56.89  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61321  Open skull for drainage                           A  30.53  20.91NA  22.39NA  20.91    22.39    10.95  62.39  63.87  62.39  63.87  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61322  Decompressive craniotomy                          A  34.26  23.03NA  24.65NA  23.03    24.65    12.21  69.50  71.12  69.50  71.12  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61323  Decompressive lobectomy                           A  35.06  22.78NA  24.33NA  22.78    24.33    12.43  70.27  71.82  70.27  71.82  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
61330  Decompress eye socket                             A  25.30  17.55NA  19.41NA  17.55    19.41     9.07  51.92  53.78  51.92  53.78  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
61332  Explore/biopsy eye socket                         A  28.60  18.96NA  20.69NA  18.96    20.69    10.24  57.80  59.53  57.80  59.53  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61333  Explore orbit/remove lesion                       A  29.27  20.52NA  23.27NA  20.52    23.27    10.48  60.27  63.02  60.27  63.02  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61334  Explore orbit/remove object                       A  19.60  12.88NA  14.29NA  12.88    14.29     7.01  39.49  40.90  39.49  40.90  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61340  Subtemporal decompression                         A  20.11  14.98NA  15.95NA  14.98    15.95     7.21  42.30  43.27  42.30  43.27  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
61343  Incise skull (press relief)                       A  31.86  21.56NA  22.61NA  21.56    22.61    11.33  64.75  65.80  64.75  65.80  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61345  Relieve cranial pressure                          A  29.23  20.40NA  21.46NA  20.40    21.46    10.47  60.10  61.16  60.10  61.16  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61440  Incise skull for surgery                          A  28.66  20.01NA  21.14NA  20.01    21.14    10.25  58.92  60.05  58.92  60.05  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61450  Incise skull for surgery                          A  27.69  18.93NA  20.06NA  18.93    20.06     9.91  56.53  57.66  56.53  57.66  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61458  Incise skull for brain wound                      A  28.84  20.09NA  21.05NA  20.09    21.05    10.23  59.16  60.12  59.16  60.12  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61460  Incise skull for surgery                          A  30.24  20.54NA  22.03NA  20.54    22.03    10.82  61.60  63.09  61.60  63.09  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
61470  Incise skull for surgery                          A  27.62  18.99NA  20.03NA  18.99    20.03     9.89  56.50  57.54  56.50  57.54  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61480  Incise skull for surgery                          A  28.05  14.77NA  14.48NA  14.77    14.48     1.97  44.79  44.50  44.79  44.50  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61490  Incise skull for surgery                          A  27.22  18.88NA  19.80NA  18.88    19.80     9.76  55.86  56.78  55.86  56.78  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
61500  Removal of skull lesion                           A  19.18  14.41NA  15.33NA  14.41    15.33     5.77  39.36  40.28  39.36  40.28  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61501  Remove infected skull bone                        A  16.35  12.84NA  13.71NA  12.84    13.71     4.66  33.85  34.72  33.85  34.72  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61510  Removal of brain lesion                           A  30.83  22.35NA  23.45NA  22.35    23.45    10.99  64.17  65.27  64.17  65.27  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61512  Remove brain lining lesion                        A  37.14  24.86NA  26.01NA  24.86    26.01    13.25  75.25  76.40  75.25  76.40  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61514  Removal of brain abscess                          A  27.23  19.05NA  19.88NA  19.05    19.88     9.70  55.98  56.81  55.98  56.81  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61516  Removal of brain lesion                           A  26.58  18.71NA  19.64NA  18.71    19.64     9.21  54.50  55.43  54.50  55.43  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61517  Implt brain chemotx add-on                        A   1.38   0.73NA   0.76NA   0.73     0.76     0.49   2.60   2.63   2.60   2.63  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
61518  Removal of brain lesion                           A  39.89  27.10NA  28.45NA  27.10    28.45    14.27  81.26  82.61  81.26  82.61  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61519  Remove brain lining lesion                        A  43.43  28.23NA  29.60NA  28.23    29.60    15.45  87.11  88.48  87.11  88.48  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61520  Removal of brain lesion                           A  57.09  36.12NA  37.88NA  36.12    37.88    17.93 111.14 112.90 111.14 112.90  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
61521  Removal of brain lesion                           A  46.99  30.17NA  31.85NA  30.17    31.85    16.83  93.99  95.67  93.99  95.67  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61522  Removal of brain abscess                          A  31.54  21.68NA  22.76NA  21.68    22.76    11.30  64.52  65.60  64.52  65.60  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61524  Removal of brain lesion                           A  29.89  20.59NA  21.83NA  20.59    21.83    10.71  61.19  62.43  61.19  62.43  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61526  Removal of brain lesion                           A  54.08  33.64NA  36.25NA  33.64    36.25    19.37 107.09 109.70 107.09 109.70  0090.11.76.1320120             25.5217 090 99      0.00   0.00   0.00
61530  Removal of brain lesion                           A  45.56  28.63NA  30.60NA  28.63    30.60    16.34  90.53  92.50  90.53  92.50  0090.11.76.1320120             25.5217 090 99      0.00   0.00   0.00
61531  Implant brain electrodes                          A  16.41  13.46NA  14.19NA  13.46    14.19     5.88  35.75  36.48  35.75  36.48  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
61533  Implant brain electrodes                          A  21.46  15.64NA  16.49NA  15.64    16.49     7.67  44.77  45.62  44.77  45.62  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61534  Removal of brain lesion                           A  23.01  17.07NA  17.98NA  17.07    17.98     8.24  48.32  49.23  48.32  49.23  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61535  Remove brain electrodes                           A  13.15  11.30NA  11.93NA  11.30    11.93     4.71  29.16  29.79  29.16  29.79  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61536  Removal of brain lesion                           A  37.72  25.05NA  26.21NA  25.05    26.21    13.51  76.28  77.44  76.28  77.44  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61537  Removal of brain tissue                           A  36.45  22.89NA  24.62NA  22.89    24.62    12.98  72.32  74.05  72.32  74.05  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61538  Removal of brain tissue                           A  39.45  24.63NA  26.64NA  24.63    26.64    14.15  78.23  80.24  78.23  80.24  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61539  Removal of brain tissue                           A  34.28  22.90NA  24.29NA  22.90    24.29    12.28  69.46  70.85  69.46  70.85  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61540  Removal of brain tissue                           A  31.43  21.73NA  22.79NA  21.73    22.79    11.26  64.42  65.48  64.42  65.48  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61541  Incision of brain tissue                          A  30.94  21.23NA  22.42NA  21.23    22.42    11.08  63.25  64.44  63.25  64.44  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61542  Removal of brain tissue                           A  33.16  20.97NA  20.48NA  20.97    20.48    11.87  66.00  65.51  66.00  65.51  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61543  Removal of brain tissue                           A  31.31  21.14NA  22.63NA  21.14    22.63    11.20  63.65  65.14  63.65  65.14  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61544  Remove & treat brain lesion                       A  27.36  17.23NA  19.88NA  17.23    19.88     9.80  54.39  57.04  54.39  57.04  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
61545  Excision of brain tumor                           A  46.43  30.77NA  32.54NA  30.77    32.54    16.62  93.82  95.59  93.82  95.59  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61546  Removal of pituitary gland                        A  33.44  22.55NA  23.82NA  22.55    23.82    11.96  67.95  69.22  67.95  69.22  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61548  Removal of pituitary gland                        A  23.37  15.98NA  16.88NA  15.98    16.88     6.65  46.00  46.90  46.00  46.90  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
61550  Release of skull seams                            A  15.59  10.62NA  10.56NA  10.62    10.56     1.10  27.31  27.25  27.31  27.25  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61552  Release of skull seams                            A  20.40  12.81NA  11.44NA  12.81    11.44     1.45  34.66  33.29  34.66  33.29  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61556  Incise skull/sutures                              A  24.09  15.71NA  15.89NA  15.71    15.89     8.64  48.44  48.62  48.44  48.62  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
61557  Incise skull/sutures                              A  23.31  17.84NA  18.61NA  17.84    18.61     8.35  49.50  50.27  49.50  50.27  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
61558  Excision of skull/sutures                         A  26.50  16.24NA  14.27NA  16.24    14.27     9.49  52.23  50.26  52.23  50.26  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
61559  Excision of skull/sutures                         A  34.02  24.42NA  25.45NA  24.42    25.45     2.40  60.84  61.87  60.84  61.87  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61563  Excision of skull tumor                           A  28.44  19.75NA  20.74NA  19.75    20.74    10.19  58.38  59.37  58.38  59.37  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61564  Excision of skull tumor                           A  34.74  23.86NA  25.00NA  23.86    25.00    12.43  71.03  72.17  71.03  72.17  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61566  Removal of brain tissue                           A  32.45  22.39NA  23.36NA  22.39    23.36    11.61  66.45  67.42  66.45  67.42  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61567  Incision of brain tissue                          A  37.00  25.59NA  26.63NA  25.59    26.63    13.27  75.86  76.90  75.86  76.90  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61570  Remove foreign body brain                         A  26.51  18.70NA  19.94NA  18.70    19.94     9.49  54.70  55.94  54.70  55.94  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61571  Incise skull for brain wound                      A  28.42  20.04NA  21.01NA  20.04    21.01    10.17  58.63  59.60  58.63  59.60  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61575  Skull base/brainstem surgery                      A  36.56  23.60NA  25.56NA  23.60    25.56    13.09  73.25  75.21  73.25  75.21  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61576  Skull base/brainstem surgery                      A  55.31  42.30NA  43.73NA  42.30    43.73     7.09 104.70 106.13 104.70 106.13  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61580  Craniofacial approach skull                       A  34.51  31.96NA  34.41NA  31.96    34.41     5.88  72.35  74.80  72.35  74.80  0090.11.76.1321112             25.5217 090 99      0.00   0.00   0.00
61581  Craniofacial approach skull                       A  39.13  35.60NA  38.59NA  35.60    38.59     5.02  79.75  82.74  79.75  82.74  0090.11.76.1321122             25.5217 090 99      0.00   0.00   0.00
61582  Craniofacial approach skull                       A  35.14  39.77NA  42.59NA  39.77    42.59    12.59  87.50  90.32  87.50  90.32  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61583  Craniofacial approach skull                       A  38.50  33.43NA  34.95NA  33.43    34.95    12.91  84.84  86.36  84.84  86.36  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61584  Orbitocranial approach/skull                      A  37.70  33.06NA  34.64NA  33.06    34.64    12.67  83.43  85.01  83.43  85.01  0090.11.76.1321212             25.5217 090 99      0.00   0.00   0.00
61585  Orbitocranial approach/skull                      A  42.57  35.18NA  38.81NA  35.18    38.81    15.25  93.00  96.63  93.00  96.63  0090.11.76.1321212             25.5217 090 99      0.00   0.00   0.00
61586  Resect nasopharynx skull                          A  27.48  31.28NA  35.11NA  31.28    35.11     9.85  68.61  72.44  68.61  72.44  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61590  Infratemporal approach/skull                      A  47.04  35.68NA  38.58NA  35.68    38.58     8.43  91.15  94.05  91.15  94.05  0090.11.76.1321212             25.5217 090 99      0.00   0.00   0.00
61591  Infratemporal approach/skull                      A  47.02  35.69NA  38.23NA  35.69    38.23     9.57  92.28  94.82  92.28  94.82  0090.11.76.1321212             25.5217 090 99      0.00   0.00   0.00
61592  Orbitocranial approach/skull                      A  43.08  35.42NA  36.93NA  35.42    36.93    14.48  92.98  94.49  92.98  94.49  0090.11.76.1321212             25.5217 090 99      0.00   0.00   0.00
61595  Transtemporal approach/skull                      A  33.74  28.97NA  30.77NA  28.97    30.77     7.13  69.84  71.64  69.84  71.64  0090.11.76.1321112             25.5217 090 99      0.00   0.00   0.00
61596  Transcochlear approach/skull                      A  39.43  29.64NA  31.60NA  29.64    31.60     5.05  74.12  76.08  74.12  76.08  0090.11.76.1321212             25.5217 090 99      0.00   0.00   0.00
61597  Transcondylar approach/skull                      A  40.82  30.02NA  31.25NA  30.02    31.25    14.63  85.47  86.70  85.47  86.70  0090.11.76.1321212             25.5217 090 99      0.00   0.00   0.00
61598  Transpetrosal approach/skull                      A  36.53  30.95NA  34.82NA  30.95    34.82    13.08  80.56  84.43  80.56  84.43  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61600  Resect/excise cranial lesion                      A  30.01  26.82NA  28.86NA  26.82    28.86     6.21  63.04  65.08  63.04  65.08  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61601  Resect/excise cranial lesion                      A  31.14  28.39NA  29.86NA  28.39    29.86    10.14  69.67  71.14  69.67  71.14  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61605  Resect/excise cranial lesion                      A  32.57  27.60NA  29.75NA  27.60    29.75     4.94  65.11  67.26  65.11  67.26  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61606  Resect/excise cranial lesion                      A  42.05  32.64NA  33.80NA  32.64    33.80    13.65  88.34  89.50  88.34  89.50  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61607  Resect/excise cranial lesion                      A  40.93  29.99NA  31.97NA  29.99    31.97    14.65  85.57  87.55  85.57  87.55  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61608  Resect/excise cranial lesion                      A  45.54  34.42NA  36.04NA  34.42    36.04    15.35  95.31  96.93  95.31  96.93  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61609  Transect artery sinus                             A   9.88   4.45NA   4.35NA   4.45     4.35     3.54  17.87  17.77  17.87  17.77  0ZZZ.00.00.0000212             25.5217 090 99      0.00   0.00   0.00
61610  Transect artery sinus                             A  29.63  15.74NA  16.57NA  15.74    16.57    10.62  55.99  56.82  55.99  56.82  0ZZZ.00.00.0000212             25.5217 090 99      0.00   0.00   0.00
61611  Transect artery sinus                             A   7.41   3.57NA   3.26NA   3.57     3.26     0.52  11.50  11.19  11.50  11.19  0ZZZ.00.00.0000212             25.5217 090 99      0.00   0.00   0.00
61612  Transect artery sinus                             A  27.84  12.84NA  12.25NA  12.84    12.25     1.96  42.64  42.05  42.64  42.05  0ZZZ.00.00.0000212             25.5217 090 99      0.00   0.00   0.00
61613  Remove aneurysm sinus                             A  45.03  34.81NA  36.99NA  34.81    36.99    16.13  95.97  98.15  95.97  98.15  0090.11.76.1321212             25.5217 090 99      0.00   0.00   0.00
61615  Resect/excise lesion skull                        A  35.77  28.45NA  29.59NA  28.45    29.59     4.59  68.81  69.95  68.81  69.95  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61616  Resect/excise lesion skull                        A  46.74  36.35NA  38.32NA  36.35    38.32    14.38  97.47  99.44  97.47  99.44  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61618  Repair dura                                       A  18.69  13.86NA  14.72NA  13.86    14.72     5.74  38.29  39.15  38.29  39.15  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61619  Repair dura                                       A  22.10  15.58NA  16.62NA  15.58    16.62     6.31  43.99  45.03  43.99  45.03  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
61623  Endovasc tempory vessel occl                      A   9.95   4.70NA   4.48NA   4.70     4.48     1.85  16.50  16.28  16.50  16.28  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
61624  Transcath occlusion cns                           A  20.12   9.14NA   8.79NA   9.14     8.79     3.76  33.02  32.67  33.02  32.67  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
61626  Transcath occlusion non-cns                       A  16.60   7.10NA   6.44NA   7.10     6.44     2.13  25.83  25.17  25.83  25.17  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
61630  Intracranial angioplasty                          R  22.07  11.64NA  11.23NA  11.64    11.23     4.17  37.88  37.47  37.88  37.47  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
61635  Intracran angioplsty w/stent                      R  24.28  12.60NA  12.14NA  12.60    12.14     4.06  40.94  40.48  40.94  40.48  0XXX.00.00.0020210             25.5217 090 99      0.00   0.00   0.00
61640  Dilate ic vasospasm init                          N+ 12.32   5.25NA   5.42NA   5.25     5.42     0.87  18.44  18.61  18.44  18.61  9000.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
61641  Dilate ic vasospasm add-on                        N+  4.33   1.85NA   1.91NA   1.85     1.91     0.31   6.49   6.55   6.49   6.55  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
61642  Dilate ic vasospasm add-on                        N+  8.66   3.69NA   3.81NA   3.69     3.81     0.61  12.96  13.08  12.96  13.08  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
61680  Intracranial vessel surgery                       A  32.55  22.49NA  23.52NA  22.49    23.52    11.65  66.69  67.72  66.69  67.72  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61682  Intracranial vessel surgery                       A  63.41  38.15NA  39.78NA  38.15    39.78    22.71 124.27 125.90 124.27 125.90  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61684  Intracranial vessel surgery                       A  41.64  27.12NA  28.86NA  27.12    28.86    14.91  83.67  85.41  83.67  85.41  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61686  Intracranial vessel surgery                       A  67.50  41.84NA  43.76NA  41.84    43.76    24.19 133.53 135.45 133.53 135.45  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61690  Intracranial vessel surgery                       A  31.34  21.74NA  22.97NA  21.74    22.97    11.23  64.31  65.54  64.31  65.54  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61692  Intracranial vessel surgery                       A  54.59  34.11NA  35.98NA  34.11    35.98    19.56 108.26 110.13 108.26 110.13  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61697  Brain aneurysm repr complx                        A  63.40  38.76NA  41.17NA  38.76    41.17    22.47 124.63 127.04 124.63 127.04  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61698  Brain aneurysm repr complx                        A  69.63  41.70NA  44.95NA  41.70    44.95    24.93 136.26 139.51 136.26 139.51  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61700  Brain aneurysm repr simple                        A  50.62  32.74NA  34.03NA  32.74    34.03    18.02 101.38 102.67 101.38 102.67  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61702  Inner skull vessel surgery                        A  60.04  36.93NA  39.59NA  36.93    39.59    21.50 118.47 121.13 118.47 121.13  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61703  Clamp neck artery                                 A  18.80  14.39NA  15.09NA  14.39    15.09     6.74  39.93  40.63  39.93  40.63  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61705  Revise circulation to head                        A  38.10  24.59NA  26.42NA  24.59    26.42    13.65  76.34  78.17  76.34  78.17  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61708  Revise circulation to head                        A  37.20  20.67NA  22.58NA  20.67    22.58     3.07  60.94  62.85  60.94  62.85  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
61710  Revise circulation to head                        A  31.29  17.18NA  16.13NA  17.18    16.13     6.50  54.97  53.92  54.97  53.92  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
61711  Fusion of skull arteries                          A  38.23  25.01NA  26.42NA  25.01    26.42    13.69  76.93  78.34  76.93  78.34  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61720  Incise skull/brain surgery                        A  17.62  12.58NA  14.05NA  12.58    14.05     6.31  36.51  37.98  36.51  37.98  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
61735  Incise skull/brain surgery                        A  22.35  14.16NA  15.01NA  14.16    15.01     8.00  44.51  45.36  44.51  45.36  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
61750  Incise skull/brain biopsy                         A  19.83  14.44NA  15.20NA  14.44    15.20     7.05  41.32  42.08  41.32  42.08  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
61751  Brain biopsy w/ct/mr guide                        A  18.79  14.84NA  15.57NA  14.84    15.57     6.68  40.31  41.04  40.31  41.04  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
61760  Implant brain electrodes                          A  22.39  15.59NA  16.93NA  15.59    16.93     8.01  45.99  47.33  45.99  47.33  0090.11.76.1320120             25.5217 090 99      0.00   0.00   0.00
61770  Incise skull for treatment                        A  23.19  15.66NA  17.17NA  15.66    17.17     8.18  47.03  48.54  47.03  48.54  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
61781  Scan proc cranial intra                           A   3.75   2.14NA   2.14NA   2.14     2.14     1.25   7.14   7.14   7.14   7.14  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
61782  Scan proc cranial extra                           A   3.18   1.81NA   1.81NA   1.81     1.81     0.87   5.86   5.86   5.86   5.86  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
61783  Scan proc spinal                                  A   3.75   2.14NA   2.14NA   2.14     2.14     0.15   6.04   6.04   6.04   6.04  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
61790  Treat trigeminal nerve                            A  11.60   9.66NA  10.44NA   9.66    10.44     4.06  25.32  26.10  25.32  26.10  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
61791  Treat trigeminal tract                            A  15.41  11.93NA  12.67NA  11.93    12.67     5.19  32.53  33.27  32.53  33.27  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
61796  Srs cranial lesion simple                         A  13.93   9.94NA  11.40NA   9.94    11.40     4.62  28.49  29.95  28.49  29.95  0090.11.76.1300200             25.5217 090 99      0.00   0.00   0.00
61797  Srs cran les simple addl                          A   3.48   1.80NA   1.94NA   1.80     1.94     1.15   6.43   6.57   6.43   6.57  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
61798  Srs cranial lesion complex                        A  19.85  11.61NA  14.69NA  11.61    14.69     6.59  38.05  41.13  38.05  41.13  0090.11.76.1300200             25.5217 090 99      0.00   0.00   0.00
61799  Srs cran les complex addl                         A   4.81   2.48NA   2.68NA   2.48     2.68     1.59   8.88   9.08   8.88   9.08  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
61800  Apply srs headframe add-on                        A   2.25   1.48NA   1.58NA   1.48     1.58     0.73   4.46   4.56   4.46   4.56  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
61850  Implant neuroelectrodes                           A  13.34   9.17NA   8.23NA   9.17     8.23     4.79  27.30  26.36  27.30  26.36  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
61860  Implant neuroelectrodes                           A  22.26  15.86NA  16.65NA  15.86    16.65     7.97  46.09  46.88  46.09  46.88  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
61863  Implant neuroelectrode                            A  20.71  15.98NA  16.69NA  15.98    16.69     7.39  44.08  44.79  44.08  44.79  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
61864  Implant neuroelectrde addl                        A   4.49   2.42NA   2.51NA   2.42     2.51     1.60   8.51   8.60   8.51   8.60  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
61867  Implant neuroelectrode                            A  33.03  22.54NA  23.62NA  22.54    23.62    11.80  67.37  68.45  67.37  68.45  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
61868  Implant neuroelectrde addl                        A   7.91   4.26NA   4.41NA   4.26     4.41     2.84  15.01  15.16  15.01  15.16  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
61870  Implant neuroelectrodes                           A  16.34  12.66NA  13.19NA  12.66    13.19     5.85  34.85  35.38  34.85  35.38  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
61875  Implant neuroelectrodes                           A  16.46  12.54NA  13.25NA  12.54    13.25     1.17  30.17  30.88  30.17  30.88  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
61880  Revise/remove neuroelectrode                      A   6.95   6.95NA   7.44NA   6.95     7.44     2.46  16.36  16.85  16.36  16.85  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
61885  Insrt/redo neurostim 1 array                      A   6.05   7.82NA   7.22NA   7.82     7.22     2.06  15.93  15.33  15.93  15.33  0090.11.76.1321000             25.5217 090 99      0.00   0.00   0.00
61886  Implant neurostim arrays                          A   9.93  10.88NA  11.59NA  10.88    11.59     3.52  24.33  25.04  24.33  25.04  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
61888  Revise/remove neuroreceiver                       A   5.23   4.54NA   4.68NA   4.54     4.68     1.71  11.48  11.62  11.48  11.62  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
62000  Treat skull fracture                              A  13.93  10.10NA  11.84NA  10.10    11.84     5.00  29.03  30.77  29.03  30.77  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
62005  Treat skull fracture                              A  17.63  13.14NA  14.06NA  13.14    14.06     6.31  37.08  38.00  37.08  38.00  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62010  Treatment of head injury                          A  21.43  15.72NA  16.72NA  15.72    16.72     7.67  44.82  45.82  44.82  45.82  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62100  Repair brain fluid leakage                        A  23.53  16.25NA  17.22NA  16.25    17.22     7.50  47.28  48.25  47.28  48.25  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62115  Reduction of skull defect                         A  22.91  11.62NA  12.99NA  11.62    12.99     1.62  36.15  37.52  36.15  37.52  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62116  Reduction of skull defect                         A  25.02  18.20NA  19.12NA  18.20    19.12     8.96  52.18  53.10  52.18  53.10  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
62117  Reduction of skull defect                         A  28.35  19.50NA  20.36NA  19.50    20.36     3.65  51.50  52.36  51.50  52.36  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62120  Repair skull cavity lesion                        A  24.59  22.83NA  23.74NA  22.83    23.74     3.16  50.58  51.49  50.58  51.49  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62121  Incise skull repair                               A  23.03  18.80NA  19.61NA  18.80    19.61     8.26  50.09  50.90  50.09  50.90  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62140  Repair of skull defect                            A  14.55  11.28NA  11.93NA  11.28    11.93     4.74  30.57  31.22  30.57  31.22  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62141  Repair of skull defect                            A  16.07  12.22NA  12.85NA  12.22    12.85     5.30  33.59  34.22  33.59  34.22  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62142  Remove skull plate/flap                           A  11.83  10.03NA  10.57NA  10.03    10.57     4.07  25.93  26.47  25.93  26.47  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
62143  Replace skull plate/flap                          A  14.15  11.21NA  11.84NA  11.21    11.84     5.00  30.36  30.99  30.36  30.99  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62145  Repair of skull & brain                           A  20.09  14.35NA  15.01NA  14.35    15.01     7.20  41.64  42.30  41.64  42.30  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62146  Repair of skull with graft                        A  17.28  12.89NA  13.86NA  12.89    13.86     6.19  36.36  37.33  36.36  37.33  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62147  Repair of skull with graft                        A  20.67  14.84NA  15.76NA  14.84    15.76     7.39  42.90  43.82  42.90  43.82  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62148  Retr bone flap to fix skull                       A   2.00   1.05NA   1.12NA   1.05     1.12     0.71   3.76   3.83   3.76   3.83  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
62160  Neuroendoscopy add-on                             A   3.00   1.61NA   1.66NA   1.61     1.66     1.07   5.68   5.73   5.68   5.73  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
62161  Dissect brain w/scope                             A  21.23  15.74NA  16.55NA  15.74    16.55     7.60  44.57  45.38  44.57  45.38  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62162  Remove colloid cyst w/scope                       A  26.80  19.34NA  20.22NA  19.34    20.22     9.59  55.73  56.61  55.73  56.61  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62163  Neuroendoscopy w/fb removal                       A  16.53  13.49NA  14.10NA  13.49    14.10     5.91  35.93  36.54  35.93  36.54  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62164  Remove brain tumor w/scope                        A  29.43  21.01NA  22.59NA  21.01    22.59    10.55  60.99  62.57  60.99  62.57  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62165  Remove pituit tumor w/scope                       A  23.23  16.45NA  17.35NA  16.45    17.35     6.36  46.04  46.94  46.04  46.94  0090.11.76.1320010             25.5217 090 99      0.00   0.00   0.00
62180  Establish brain cavity shunt                      A  22.58  16.43NA  17.26NA  16.43    17.26     8.09  47.10  47.93  47.10  47.93  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
62190  Establish brain cavity shunt                      A  12.17  10.39NA  11.01NA  10.39    11.01     4.36  26.92  27.54  26.92  27.54  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
62192  Establish brain cavity shunt                      A  13.35  10.55NA  11.18NA  10.55    11.18     4.62  28.52  29.15  28.52  29.15  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62194  Replace/irrigate catheter                         A   5.78   5.28NA   6.56NA   5.28     6.56     0.45  11.51  12.79  11.51  12.79  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
62200  Establish brain cavity shunt                      A  19.29  14.24NA  14.99NA  14.24    14.99     6.91  40.44  41.19  40.44  41.19  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62201  Brain cavity shunt w/scope                        A  16.04  13.35NA  14.13NA  13.35    14.13     5.72  35.11  35.89  35.11  35.89  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
62220  Establish brain cavity shunt                      A  14.10  10.84NA  11.50NA  10.84    11.50     4.82  29.76  30.42  29.76  30.42  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62223  Establish brain cavity shunt                      A  14.05  11.88NA  12.49NA  11.88    12.49     4.83  30.76  31.37  30.76  31.37  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62225  Replace/irrigate catheter                         A   6.19   6.58NA   7.03NA   6.58     7.03     2.20  14.97  15.42  14.97  15.42  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
62230  Replace/revise brain shunt                        A  11.43   9.21NA   9.69NA   9.21     9.69     3.97  24.61  25.09  24.61  25.09  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62252  Csf shunt reprogram                               A   0.74   1.72     1.43     1.72NA   1.43 NA  0.25   2.71   2.42   2.71   2.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
62252TCCsf shunt reprogram                               A   0.00   1.33     1.02     1.33NA   1.02 NA  0.01   1.34   1.03   1.34   1.03  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
6225226Csf shunt reprogram                               A   0.74   0.39     0.41     0.39     0.41     0.24   1.37   1.39   1.37   1.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
62256  Remove brain cavity shunt                         A   7.38   7.35NA   7.78NA   7.35     7.78     2.62  17.35  17.78  17.35  17.78  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
62258  Replace brain cavity shunt                        A  15.64  11.87NA  12.43NA  11.87    12.43     5.42  32.93  33.49  32.93  33.49  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
62263  Epidural lysis mult sessions                      A   6.54  13.85    15.67     4.72     5.76     0.52  20.91  22.73  11.78  12.82  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
62264  Epidural lysis on single day                      A   4.42   7.40     8.07     2.07     2.54     0.35  12.17  12.84   6.84   7.31  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
62267  Interdiscal perq aspir dx                         A   3.00   3.98     3.81     1.39     1.37     0.30   7.28   7.11   4.69   4.67  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
62268  Drain spinal cord cyst                            A   4.73   5.21     2.04     2.46     2.53     0.45  10.39   7.22   7.64   7.71  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62269  Needle biopsy spinal cord                         A   5.01   5.61     1.92     2.27     2.31     0.56  11.18   7.49   7.84   7.88  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
62270  Spinal fluid tap diagnostic                       A   1.37   2.98     2.86     0.72     0.71     0.23   4.58   4.46   2.32   2.31  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62272  Drain cerebro spinal fluid                        A   1.35   4.00     4.08     0.83     0.84     0.33   5.68   5.76   2.51   2.52  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62273  Inject epidural patch                             A   2.15   2.59     2.76     0.93     1.08     0.20   4.94   5.11   3.28   3.43  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62280  Treat spinal cord lesion                          A   2.63   6.41     6.74     1.64     1.92     0.50   9.54   9.87   4.77   5.05  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
62281  Treat spinal cord lesion                          A   2.66   4.71     4.03     1.48     1.73     0.27   7.64   6.96   4.41   4.66  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
62282  Treat spinal canal lesion                         A   2.33   6.03     5.90     1.50     1.70     0.29   8.65   8.52   4.12   4.32  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
62284  Injection for myelogram                           A   1.54   4.58     4.18     0.86     0.81     0.18   6.30   5.90   2.58   2.53  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62287  Percutaneous diskectomy                           A   9.03   6.35NA   6.89NA   6.35     6.89     0.81  16.19  16.73  16.19  16.73  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
62290  Inject for spine disk x-ray                       A   3.00   6.49     6.65     1.73     1.92     0.30   9.79   9.95   5.03   5.22  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62291  Inject for spine disk x-ray                       A   2.91   6.06     6.34     1.67     1.88     0.27   9.24   9.52   4.85   5.06  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62292  Injection into disk lesion                        A   9.24   6.05NA   8.48NA   6.05     8.48     0.75  16.04  18.47  16.04  18.47  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
62294  Injection into spinal artery                      A  12.87   6.34NA   4.63NA   6.34     4.63     1.02  20.23  18.52  20.23  18.52  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
62310  Inject spine c/t                                  A   1.91   4.73     5.15     0.98     1.20     0.16   6.80   7.22   3.05   3.27  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62311  Inject spine l/s (cd)                             A   1.54   4.18     4.37     0.84     0.99     0.12   5.84   6.03   2.50   2.65  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62318  Inject spine w/cath c/t                           A   2.04   4.79     4.98     0.72     0.84     0.16   6.99   7.18   2.92   3.04  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62319  Inject spine w/cath l/s (cd)                      A   1.87   3.54     2.98     0.74     0.87     0.16   5.57   5.01   2.77   2.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
62350  Implant spinal canal cath                         A   6.05   4.38NA   4.95NA   4.38     4.95     1.05  11.48  12.05  11.48  12.05  0010.10.80.1020110             25.5217 090 99      0.00   0.00   0.00
62351  Implant spinal canal cath                         A  11.66  10.10NA  10.89NA  10.10    10.89     3.38  25.14  25.93  25.14  25.93  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
62355  Remove spinal canal catheter                      A   4.35   3.59NA   4.02NA   3.59     4.02     0.73   8.67   9.10   8.67   9.10  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
62360  Insert spine infusion device                      A   4.33   3.66NA   4.18NA   3.66     4.18     0.87   8.86   9.38   8.86   9.38  0010.10.80.1020010             25.5217 090 99      0.00   0.00   0.00
62361  Implant spine infusion pump                       A   5.65   4.69NA   4.95NA   4.69     4.95     1.10  11.44  11.70  11.44  11.70  0010.10.80.1020010             25.5217 090 99      0.00   0.00   0.00
62362  Implant spine infusion pump                       A   6.10   4.67NA   5.10NA   4.67     5.10     1.22  11.99  12.42  11.99  12.42  0010.10.80.1020010             25.5217 090 99      0.00   0.00   0.00
62365  Remove spine infusion device                      A   4.65   4.03NA   4.43NA   4.03     4.43     0.88   9.56   9.96   9.56   9.96  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
62367  Analyze spine infusion pump                       A   0.48   0.66     0.72     0.19     0.23     0.05   1.19   1.25   0.72   0.76  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
62368  Analyze spine infusion pump                       A   0.75   0.88     1.01     0.30     0.37     0.07   1.70   1.83   1.12   1.19  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
63001  Removal of spinal lamina                          A  17.61  12.96NA  13.71NA  12.96    13.71     5.68  36.25  37.00  36.25  37.00  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63003  Removal of spinal lamina                          A  17.74  13.05NA  13.78NA  13.05    13.78     5.62  36.41  37.14  36.41  37.14  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63005  Removal of spinal lamina                          A  16.43  13.08NA  13.71NA  13.08    13.71     5.07  34.58  35.21  34.58  35.21  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63011  Removal of spinal lamina                          A  15.91  11.93NA  12.76NA  11.93    12.76     4.01  31.85  32.68  31.85  32.68  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63012  Removal of spinal lamina                          A  16.85  12.96NA  13.53NA  12.96    13.53     5.09  34.90  35.47  34.90  35.47  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63015  Removal of spinal lamina                          A  20.85  15.69NA  16.47NA  15.69    16.47     6.99  43.53  44.31  43.53  44.31  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63016  Removal of spinal lamina                          A  22.03  15.73NA  16.65NA  15.73    16.65     6.76  44.52  45.44  44.52  45.44  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63017  Removal of spinal lamina                          A  17.33  13.71NA  14.40NA  13.71    14.40     5.55  36.59  37.28  36.59  37.28  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63020  Neck spine disk surgery                           A  16.20  12.98NA  13.61NA  12.98    13.61     5.05  34.23  34.86  34.23  34.86  0090.11.76.1321220             25.5217 090 99      0.00   0.00   0.00
63030  Low back disk surgery                             A  13.18  11.30NA  11.89NA  11.30    11.89     3.86  28.34  28.93  28.34  28.93  0090.11.76.1321220             25.5217 090 99      0.00   0.00   0.00
63035  Spinal disk surgery add-on                        A   3.15   1.74NA   1.80NA   1.74     1.80     0.88   5.77   5.83   5.77   5.83  0ZZZ.00.00.0001220             25.5217 090 99      0.00   0.00   0.00
63040  Laminotomy single cervical                        A  20.31  14.73NA  15.47NA  14.73    15.47     6.26  41.30  42.04  41.30  42.04  0090.11.76.1321220             25.5217 090 99      0.00   0.00   0.00
63042  Laminotomy single lumbar                          A  18.76  14.27NA  14.97NA  14.27    14.97     5.19  38.22  38.92  38.22  38.92  0090.11.76.1321220             25.5217 090 99      0.00   0.00   0.00
63043  Laminotomy addl cervical                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0001220             25.5217 090 99      0.00   0.00   0.00
63044  Laminotomy addl lumbar                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0001220             25.5217 090 99      0.00   0.00   0.00
63045  Removal of spinal lamina                          A  17.95  13.65NA  14.34NA  13.65    14.34     5.72  37.32  38.01  37.32  38.01  0090.11.76.1322220             25.5217 090 99      0.00   0.00   0.00
63046  Removal of spinal lamina                          A  17.25  13.16NA  13.83NA  13.16    13.83     5.13  35.54  36.21  35.54  36.21  0090.11.76.1322220             25.5217 090 99      0.00   0.00   0.00
63047  Removal of spinal lamina                          A  15.37  12.50NA  13.09NA  12.50    13.09     4.40  32.27  32.86  32.27  32.86  0090.11.76.1322220             25.5217 090 99      0.00   0.00   0.00
63048  Remove spinal lamina add-on                       A   3.47   1.90NA   1.98NA   1.90     1.98     1.00   6.37   6.45   6.37   6.45  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
63050  Cervical laminoplasty                             A  22.01  16.26NA  17.41NA  16.26    17.41     7.89  46.16  47.31  46.16  47.31  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63051  C-laminoplasty w/graft/plate                      A  25.51  17.76NA  18.77NA  17.76    18.77     7.22  50.49  51.50  50.49  51.50  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63055  Decompress spinal cord                            A  23.55  16.74NA  17.54NA  16.74    17.54     7.65  47.94  48.74  47.94  48.74  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63056  Decompress spinal cord                            A  21.86  15.52NA  16.34NA  15.52    16.34     6.18  43.56  44.38  43.56  44.38  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63057  Decompress spine cord add-on                      A   5.25   2.88NA   3.00NA   2.88     3.00     1.51   9.64   9.76   9.64   9.76  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
63064  Decompress spinal cord                            A  26.22  17.92NA  18.93NA  17.92    18.93     7.93  52.07  53.08  52.07  53.08  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63066  Decompress spine cord add-on                      A   3.26   1.77NA   1.82NA   1.77     1.82     1.17   6.20   6.25   6.20   6.25  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
63075  Neck spine disk surgery                           A  19.60  14.78NA  15.40NA  14.78    15.40     6.10  40.48  41.10  40.48  41.10  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63076  Neck spine disk surgery                           A   4.04   2.21NA   2.29NA   2.21     2.29     1.25   7.50   7.58   7.50   7.58  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
63077  Spine disk surgery thorax                         A  22.88  15.50NA  16.29NA  15.50    16.29     5.85  44.23  45.02  44.23  45.02  0090.11.76.1320220             25.5217 090 99      0.00   0.00   0.00
63078  Spine disk surgery thorax                         A   3.28   1.78NA   1.87NA   1.78     1.87     0.75   5.81   5.90   5.81   5.90  0ZZZ.00.00.0000220             25.5217 090 99      0.00   0.00   0.00
63081  Removal of vertebral body                         A  26.10  18.25NA  19.18NA  18.25    19.18     7.88  52.23  53.16  52.23  53.16  0090.11.76.1320212             25.5217 090 99      0.00   0.00   0.00
63082  Remove vertebral body add-on                      A   4.36   2.39NA   2.48NA   2.39     2.48     1.30   8.05   8.14   8.05   8.14  0ZZZ.00.00.0000212             25.5217 090 99      0.00   0.00   0.00
63085  Removal of vertebral body                         A  29.47  18.64NA  19.52NA  18.64    19.52     7.92  56.03  56.91  56.03  56.91  0090.11.76.1320222             25.5217 090 99      0.00   0.00   0.00
63086  Remove vertebral body add-on                      A   3.19   1.68NA   1.72NA   1.68     1.72     0.87   5.74   5.78   5.74   5.78  0ZZZ.00.00.0000222             25.5217 090 99      0.00   0.00   0.00
63087  Removal of vertebral body                         A  37.53  23.44NA  24.49NA  23.44    24.49     9.71  70.68  71.73  70.68  71.73  0090.11.76.1320222             25.5217 090 99      0.00   0.00   0.00
63088  Remove vertebral body add-on                      A   4.32   2.38NA   2.48NA   2.38     2.48     1.06   7.76   7.86   7.76   7.86  0ZZZ.00.00.0000222             25.5217 090 99      0.00   0.00   0.00
63090  Removal of vertebral body                         A  30.93  19.96NA  21.10NA  19.96    21.10     7.18  58.07  59.21  58.07  59.21  0090.11.76.1320222             25.5217 090 99      0.00   0.00   0.00
63091  Remove vertebral body add-on                      A   3.03   1.63NA   1.70NA   1.63     1.70     0.68   5.34   5.41   5.34   5.41  0ZZZ.00.00.0000222             25.5217 090 99      0.00   0.00   0.00
63101  Removal of vertebral body                         A  34.10  23.73NA  24.98NA  23.73    24.98    10.61  68.44  69.69  68.44  69.69  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63102  Removal of vertebral body                         A  34.10  23.40NA  24.62NA  23.40    24.62     8.58  66.08  67.30  66.08  67.30  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63103  Remove vertebral body add-on                      A   4.82   2.67NA   2.75NA   2.67     2.75     1.29   8.78   8.86   8.78   8.86  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
63170  Incise spinal cord tract(s)                       A  22.21  16.25NA  17.49NA  16.25    17.49     7.96  46.42  47.66  46.42  47.66  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63172  Drainage of spinal cyst                           A  19.76  14.50NA  15.32NA  14.50    15.32     7.06  41.32  42.14  41.32  42.14  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63173  Drainage of spinal cyst                           A  24.31  17.73NA  18.66NA  17.73    18.66     8.73  50.77  51.70  50.77  51.70  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63180  Revise spinal cord ligaments                      A  20.53  14.99NA  16.55NA  14.99    16.55     7.35  42.87  44.43  42.87  44.43  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63182  Revise spinal cord ligaments                      A  22.82  15.15NA  17.83NA  15.15    17.83     8.18  46.15  48.83  46.15  48.83  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63185  Incise spinal column/nerves                       A  16.49  12.46NA  13.34NA  12.46    13.34     5.91  34.86  35.74  34.86  35.74  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63190  Incise spinal column/nerves                       A  18.89  14.11NA  14.90NA  14.11    14.90     4.28  37.28  38.07  37.28  38.07  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63191  Incise spinal column/nerves                       A  18.92  12.23NA  15.50NA  12.23    15.50     3.73  34.88  38.15  34.88  38.15  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
63194  Incise spinal column & cord                       A  22.10  15.43NA  16.17NA  15.43    16.17     2.84  40.37  41.11  40.37  41.11  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63195  Incise spinal column & cord                       A  21.64  15.54NA  16.63NA  15.54    16.63     7.75  44.93  46.02  44.93  46.02  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63196  Incise spinal column & cord                       A  25.27  15.30NA  13.49NA  15.30    13.49     1.79  42.36  40.55  42.36  40.55  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63197  Incise spinal column & cord                       A  24.08  17.53NA  18.53NA  17.53    18.53     8.64  50.25  51.25  50.25  51.25  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63198  Incise spinal column & cord                       A  29.90  14.84NA  15.75NA  14.84    15.75     2.12  46.86  47.77  46.86  47.77  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63199  Incise spinal column & cord                       A  31.47  17.96NA  16.44NA  17.96    16.44     2.23  51.66  50.14  51.66  50.14  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63200  Release of spinal cord                            A  21.44  15.70NA  16.60NA  15.70    16.60     7.56  44.70  45.60  44.70  45.60  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
63250  Revise spinal cord vessels                        A  43.86  27.92NA  29.65NA  27.92    29.65    15.71  87.49  89.22  87.49  89.22  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63251  Revise spinal cord vessels                        A  44.64  28.98NA  30.54NA  28.98    30.54    16.00  89.62  91.18  89.62  91.18  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63252  Revise spinal cord vessels                        A  44.63  28.93NA  30.54NA  28.93    30.54    16.00  89.56  91.17  89.56  91.17  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63265  Excise intraspinal lesion                         A  23.82  17.18NA  18.05NA  17.18    18.05     8.07  49.07  49.94  49.07  49.94  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63266  Excise intraspinal lesion                         A  24.68  17.48NA  18.41NA  17.48    18.41     8.38  50.54  51.47  50.54  51.47  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63267  Excise intraspinal lesion                         A  19.45  14.70NA  15.42NA  14.70    15.42     6.25  40.40  41.12  40.40  41.12  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63268  Excise intraspinal lesion                         A  20.02  15.16NA  16.31NA  15.16    16.31     7.17  42.35  43.50  42.35  43.50  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63270  Excise intraspinal lesion                         A  29.80  20.55NA  21.78NA  20.55    21.78    10.69  61.04  62.27  61.04  62.27  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63271  Excise intraspinal lesion                         A  29.92  20.53NA  21.58NA  20.53    21.58    10.55  61.00  62.05  61.00  62.05  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63272  Excise intraspinal lesion                         A  27.50  19.10NA  20.03NA  19.10    20.03     9.45  56.05  56.98  56.05  56.98  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63273  Excise intraspinal lesion                         A  26.47  18.29NA  19.92NA  18.29    19.92     9.48  54.24  55.87  54.24  55.87  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
63275  Biopsy/excise spinal tumor                        A  25.86  18.15NA  19.12NA  18.15    19.12     8.80  52.81  53.78  52.81  53.78  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63276  Biopsy/excise spinal tumor                        A  25.69  18.13NA  19.09NA  18.13    19.09     8.69  52.51  53.47  52.51  53.47  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63277  Biopsy/excise spinal tumor                        A  22.39  16.25NA  17.12NA  16.25    17.12     6.98  45.62  46.49  45.62  46.49  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63278  Biopsy/excise spinal tumor                        A  22.12  16.31NA  17.49NA  16.31    17.49     7.93  46.36  47.54  46.36  47.54  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63280  Biopsy/excise spinal tumor                        A  30.29  21.23NA  22.13NA  21.23    22.13    10.81  62.33  63.23  62.33  63.23  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63281  Biopsy/excise spinal tumor                        A  29.99  21.07NA  22.09NA  21.07    22.09    10.65  61.71  62.73  61.71  62.73  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63282  Biopsy/excise spinal tumor                        A  28.15  20.05NA  20.96NA  20.05    20.96     9.93  58.13  59.04  58.13  59.04  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63283  Biopsy/excise spinal tumor                        A  26.76  19.35NA  20.54NA  19.35    20.54     9.57  55.68  56.87  55.68  56.87  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63285  Biopsy/excise spinal tumor                        A  38.05  25.09NA  26.58NA  25.09    26.58    13.63  76.77  78.26  76.77  78.26  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63286  Biopsy/excise spinal tumor                        A  37.62  25.05NA  26.26NA  25.05    26.26    13.17  75.84  77.05  75.84  77.05  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63287  Biopsy/excise spinal tumor                        A  40.08  26.46NA  27.99NA  26.46    27.99    14.37  80.91  82.44  80.91  82.44  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63290  Biopsy/excise spinal tumor                        A  40.82  26.64NA  28.00NA  26.64    28.00    14.63  82.09  83.45  82.09  83.45  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63295  Repair of laminectomy defect                      A   5.25   2.74NA   2.94NA   2.74     2.94     1.87   9.86  10.06   9.86  10.06  0ZZZ.00.00.0002220             25.5217 090 99      0.00   0.00   0.00
63300  Removal of vertebral body                         A  26.80  18.51NA  19.47NA  18.51    19.47     8.66  53.97  54.93  53.97  54.93  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63301  Removal of vertebral body                         A  31.57  21.07NA  23.23NA  21.07    23.23    11.31  63.95  66.11  63.95  66.11  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63302  Removal of vertebral body                         A  31.15  20.96NA  23.00NA  20.96    23.00    11.15  63.26  65.30  63.26  65.30  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63303  Removal of vertebral body                         A  33.55  21.66NA  23.88NA  21.66    23.88    12.00  67.21  69.43  67.21  69.43  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63304  Removal of vertebral body                         A  33.85  23.07NA  24.51NA  23.07    24.51    12.11  69.03  70.47  69.03  70.47  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63305  Removal of vertebral body                         A  36.24  23.21NA  25.75NA  23.21    25.75    12.98  72.43  74.97  72.43  74.97  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63306  Removal of vertebral body                         A  35.55  19.30NA  15.91NA  19.30    15.91    12.74  67.59  64.20  67.59  64.20  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63307  Removal of vertebral body                         A  34.96  23.07NA  24.75NA  23.07    24.75    12.53  70.56  72.24  70.56  72.24  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63308  Remove vertebral body add-on                      A   5.24   2.82NA   2.91NA   2.82     2.91     1.56   9.62   9.71   9.62   9.71  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
63600  Remove spinal cord lesion                         A  15.12   8.20NA  10.46NA   8.20    10.46     1.58  24.90  27.16  24.90  27.16  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
63610  Stimulation of spinal cord                        A   8.72  15.94     2.03     2.33     2.41     0.68  25.34  11.43  11.73  11.81  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
63615  Remove lesion of spinal cord                      A  17.32  12.25NA  13.50NA  12.25    13.50     6.19  35.76  37.01  35.76  37.01  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
63620  Srs spinal lesion                                 A  15.60  10.34NA  12.19NA  10.34    12.19     5.17  31.11  32.96  31.11  32.96  0090.11.76.1300200             25.5217 090 99      0.00   0.00   0.00
63621  Srs spinal lesion addl                            A   4.00   2.07NA   2.24NA   2.07     2.24     1.32   7.39   7.56   7.39   7.56  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
63650  Implant neuroelectrodes                           A   7.20   4.39NA   5.26NA   4.39     5.26     0.64  12.23  13.10  12.23  13.10  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
63655  Implant neuroelectrodes                           A  11.56  10.04NA  10.74NA  10.04    10.74     3.61  25.21  25.91  25.21  25.91  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63661  Remove spine eltrd perq aray                      A   5.08  11.83    11.83     3.94     3.94     0.71  17.62  17.62   9.73   9.73  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
63662  Remove spine eltrd plate                          A  11.00   8.57NA   8.57NA   8.57     8.57     1.55  21.12  21.12  21.12  21.12  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63663  Revise spine eltrd perq aray                      A   7.75  16.34    16.34     5.29     5.29     1.09  25.18  25.18  14.13  14.13  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
63664  Revise spine eltrd plate                          A  11.52   8.83NA   8.83NA   8.83     8.83     1.60  21.95  21.95  21.95  21.95  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63685  Insrt/redo spine n generator                      A   6.05   4.54NA   5.10NA   4.54     5.10     1.10  11.69  12.25  11.69  12.25  0010.10.80.1020210             25.5217 090 99      0.00   0.00   0.00
63688  Revise/remove neuroreceiver                       A   5.30   4.25NA   4.74NA   4.25     4.74     1.00  10.55  11.04  10.55  11.04  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
63700  Repair of spinal herniation                       A  17.47  13.85NA  15.02NA  13.85    15.02     6.25  37.57  38.74  37.57  38.74  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63702  Repair of spinal herniation                       A  19.41  15.25NA  16.10NA  15.25    16.10     6.95  41.61  42.46  41.61  42.46  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63704  Repair of spinal herniation                       A  22.43  16.95NA  18.79NA  16.95    18.79     8.03  47.41  49.25  47.41  49.25  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63706  Repair of spinal herniation                       A  25.35  19.10NA  20.42NA  19.10    20.42     9.10  53.55  54.87  53.55  54.87  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63707  Repair spinal fluid leakage                       A  12.65  10.42NA  11.06NA  10.42    11.06     3.49  26.56  27.20  26.56  27.20  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63709  Repair spinal fluid leakage                       A  15.65  12.10NA  12.73NA  12.10    12.73     4.49  32.24  32.87  32.24  32.87  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63710  Graft repair of spine defect                      A  15.40  12.13NA  12.78NA  12.13    12.78     4.85  32.38  33.03  32.38  33.03  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63740  Install spinal shunt                              A  12.63  10.64NA  11.01NA  10.64    11.01     4.25  27.52  27.89  27.52  27.89  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63741  Install spinal shunt                              A   9.12   6.69NA   7.60NA   6.69     7.60     2.19  18.00  18.91  18.00  18.91  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63744  Revision of spinal shunt                          A   8.94   7.40NA   8.09NA   7.40     8.09     3.06  19.40  20.09  19.40  20.09  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
63746  Removal of spinal shunt                           A   7.33   7.20NA   7.84NA   7.20     7.84     2.62  17.15  17.79  17.15  17.79  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
64400  N block inj trigeminal                            A   1.11   2.04     2.18     0.67     0.78     0.18   3.33   3.47   1.96   2.07  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64402  N block inj facial                                A   1.25   1.89     1.99     0.71     0.79     0.18   3.32   3.42   2.14   2.22  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64405  N block inj occipital                             A   1.32   1.73     1.95     0.76     0.90     0.26   3.31   3.53   2.34   2.48  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64408  N block inj vagus                                 A   1.41   2.05     2.21     1.11     1.24     0.16   3.62   3.78   2.68   2.81  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
64410  N block inj phrenic                               A   1.43   2.61     2.75     0.70     0.76     0.33   4.37   4.51   2.46   2.52  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
64412  N block inj spinal accessor                       A   1.18   3.02     3.26     0.81     0.92     0.20   4.40   4.64   2.19   2.30  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64413  N block inj cervical plexus                       A   1.40   1.89     2.01     0.73     0.83     0.20   3.49   3.61   2.33   2.43  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64415  N block inj brachial plexus                       A   1.48   2.02     1.90     0.40     0.36     0.11   3.61   3.49   1.99   1.95  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64416  N block cont infuse b plex                        A   1.81   0.44NA   0.43NA   0.44     0.43     0.14   2.39   2.38   2.39   2.38  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64417  N block inj axillary                              A   1.44   2.24     2.25     0.50     0.56     0.11   3.79   3.80   2.05   2.11  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64418  N block inj suprascapular                         A   1.32   2.60     2.70     0.73     0.83     0.12   4.04   4.14   2.17   2.27  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64420  N block inj intercost sng                         A   1.18   2.71     2.01     0.66     0.77     0.12   4.01   3.31   1.96   2.07  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
64421  N block inj intercost mlt                         A   1.68   3.88     2.64     0.82     0.97     0.20   5.76   4.52   2.70   2.85  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64425  N block inj ilio-ing/hypogi                       A   1.75   1.90     2.08     0.82     0.96     0.20   3.85   4.03   2.77   2.91  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64430  N block inj pudendal                              A   1.46   2.62     2.26     0.85     0.79     0.14   4.22   3.86   2.45   2.39  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64435  N block inj paracervical                          A   1.45   2.47     2.36     0.77     0.79     0.24   4.16   4.05   2.46   2.48  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64445  N block inj sciatic sng                           A   1.48   2.30     2.30     0.58     0.54     0.16   3.94   3.94   2.22   2.18  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64446  N blk inj sciatic cont inf                        A   1.81   0.48NA   0.44NA   0.48     0.44     0.14   2.43   2.39   2.43   2.39  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64447  N block inj fem single                            A   1.50   1.89     1.89     0.33     0.36     0.11   3.50   3.50   1.94   1.97  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64448  N block inj fem cont inf                          A   1.63   0.41NA   0.39NA   0.41     0.39     0.12   2.16   2.14   2.16   2.14  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64449  N block inj lumbar plexus                         A   1.81   0.53NA   0.51NA   0.53     0.51     0.14   2.48   2.46   2.48   2.46  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64450  N block other peripheral                          A   1.27   1.63     1.73     0.64     0.68     0.11   3.01   3.11   2.02   2.06  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64455  N block inj plantar digit                         A   0.75   0.61     0.59     0.27     0.24     0.08   1.44   1.42   1.10   1.07  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
64479  Inj foramen epidural c/t                          A   2.29   5.27     4.76     1.30     1.54     0.27   7.83   7.32   3.86   4.10  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64480  Inj foramen epidural add-on                       A   1.20   2.35     2.36     0.59     0.64     0.18   3.73   3.74   1.97   2.02  0ZZZ.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
64483  Inj foramen epidural l/s                          A   1.90   5.23     4.55     1.16     1.35     0.16   7.29   6.61   3.22   3.41  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
64484  Inj foramen epidural add-on                       A   1.00   2.06     1.61     0.48     0.52     0.08   3.14   2.69   1.56   1.60  0ZZZ.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
64490  Inj paravert f jnt c/t 1 lev                      A   1.82   3.78     3.78     1.26     1.26     0.20   5.80   5.80   3.28   3.28  0000.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
64491  Inj paravert f jnt c/t 2 lev                      A   1.16   1.59     1.59     0.58     0.58     0.11   2.86   2.86   1.85   1.85  0ZZZ.00.00.0001200             25.5217 090 99      0.00   0.00   0.00
64492  Inj paravert f jnt c/t 3 lev                      A   1.16   1.63     1.63     0.61     0.61     0.11   2.90   2.90   1.88   1.88  0ZZZ.00.00.0001200             25.5217 090 99      0.00   0.00   0.00
64493  Inj paravert f jnt l/s 1 lev                      A   1.52   3.50     3.50     1.10     1.10     0.14   5.16   5.16   2.76   2.76  0000.00.00.0021200             25.5217 090 99      0.00   0.00   0.00
64494  Inj paravert f jnt l/s 2 lev                      A   1.00   1.51     1.51     0.49     0.49     0.08   2.59   2.59   1.57   1.57  0ZZZ.00.00.0001200             25.5217 090 99      0.00   0.00   0.00
64495  Inj paravert f jnt l/s 3 lev                      A   1.00   1.54     1.54     0.52     0.52     0.08   2.62   2.62   1.60   1.60  0ZZZ.00.00.0001200             25.5217 090 99      0.00   0.00   0.00
64505  N block spenopalatine gangl                       A   1.36   1.43     1.45     0.95     1.02     0.10   2.89   2.91   2.41   2.48  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
64508  N block carotid sinus s/p                         A   1.12   1.72     0.50     0.85     0.94     0.24   3.08   1.86   2.21   2.30  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
64510  N block stellate ganglion                         A   1.22   2.65     2.49     0.74     0.90     0.10   3.97   3.81   2.06   2.22  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
64517  N block inj hypogas plxs                          A   2.20   2.73     2.99     1.15     1.35     0.18   5.11   5.37   3.53   3.73  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
64520  N block lumbar/thoracic                           A   1.35   4.18     4.33     0.85     1.01     0.11   5.64   5.79   2.31   2.47  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
64530  N block inj celiac pelus                          A   1.58   3.99     4.06     0.94     1.06     0.14   5.71   5.78   2.66   2.78  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
64550  Apply neurostimulator                             A   0.18   0.27     0.29     0.07     0.08     0.01   0.46   0.48   0.26   0.27  0000.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
64553  Implant neuroelectrodes                           A   2.36   3.33     3.39     1.97     2.01     0.38   6.07   6.13   4.71   4.75  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
64555  Implant neuroelectrodes                           A   2.32   3.35     3.02     1.80     1.72     0.26   5.93   5.60   4.38   4.30  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
64560  Implant neuroelectrodes                           A   2.41   4.19     4.85     2.20     2.50     0.16   6.76   7.42   4.77   5.07  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
64561  Implant neuroelectrodes                           A   7.15  20.88    14.88     4.17     3.88     0.77  28.80  22.80  12.09  11.80  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
64565  Implant neuroelectrodes                           A   1.81   3.15     3.31     1.61     1.81     0.24   5.20   5.36   3.66   3.86  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
64566  Neuroeltrd stim post tibial                       A   0.60   3.17     3.17     0.23     0.23     0.05   3.82   3.82   0.88   0.88  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
64568  Inc for vagus n elect impl                        A   9.00   8.67NA   8.67NA   8.67     8.67     1.25  18.92  18.92  18.92  18.92  0090.11.76.1321000             25.5217 090 99      0.00   0.00   0.00
64569  Revise/repl vagus n eltrd                         A  11.00   4.50NA   4.50NA   4.50     4.50     3.15  18.65  18.65  18.65  18.65  0090.11.76.1321011             25.5217 090 99      0.00   0.00   0.00
64570  Remove vagus n eltrd                              A   9.10   4.06NA   4.06NA   4.06     4.06     3.26  16.42  16.42  16.42  16.42  0090.11.76.1321011             25.5217 090 99      0.00   0.00   0.00
64575  Implant neuroelectrodes                           A   4.42   3.58NA   4.21NA   3.58     4.21     0.43   8.43   9.06   8.43   9.06  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64577  Implant neuroelectrodes                           A   4.69   3.54NA   2.75NA   3.54     2.75     1.67   9.90   9.11   9.90   9.11  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64580  Implant neuroelectrodes                           A   4.19   3.82NA   3.92NA   3.82     3.92     0.88   8.89   8.99   8.89   8.99  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64581  Implant neuroelectrodes                           A  12.20   7.05NA   6.04NA   7.05     6.04     1.58  20.83  19.82  20.83  19.82  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64585  Revise/remove neuroelectrode                      A   2.11   6.22     4.75     2.10     1.89     0.27   8.60   7.13   4.48   4.27  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
64590  Insrt/redo pn/gastr stimul                        A   2.45   5.71     4.76     2.22     1.96     0.29   8.45   7.50   4.96   4.70  0010.10.80.1020110             25.5217 090 99      0.00   0.00   0.00
64595  Revise/rmv pn/gastr stimul                        A   1.78   6.38     4.97     1.92     1.70     0.22   8.38   6.97   3.92   3.70  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
64600  Injection treatment of nerve                      A   3.49   8.08     8.24     2.46     2.81     0.53  12.10  12.26   6.48   6.83  0010.10.80.1022100             25.5217 090 99      0.00   0.00   0.00
64605  Injection treatment of nerve                      A   5.65  13.00    15.95     3.93     4.84     0.43  19.08  22.03  10.01  10.92  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
64610  Injection treatment of nerve                      A   7.20  12.12    13.02     5.00     5.26     2.15  21.47  22.37  14.35  14.61  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
64611  Chemodenerv saliv glands                          A   1.03   1.64     1.64     1.35     1.35     0.29   2.96   2.96   2.67   2.67  0010.10.80.1022000             25.5217 090 99      0.00   0.00   0.00
64612  Destroy nerve face muscle                         A   2.01   2.39     2.52     1.93     2.19     0.65   5.05   5.18   4.59   4.85  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
64613  Destroy nerve neck muscle                         A   2.01   2.24     2.29     1.69     1.93     0.58   4.83   4.88   4.28   4.52  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
64614  Destroy nerve extrem musc                         A   2.20   2.54     2.59     1.86     2.09     0.42   5.16   5.21   4.48   4.71  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
64620  Injection treatment of nerve                      A   2.89   3.87     3.06     1.82     2.12     0.29   7.05   6.24   5.00   5.30  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
64622  Destr paravertebrl nerve l/s                      A   3.05   6.57     6.96     2.08     2.51     0.26   9.88  10.27   5.39   5.82  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
64623  Destr paravertebral n add-on                      A   0.99   2.61     2.76     0.40     0.51     0.08   3.68   3.83   1.47   1.58  0ZZZ.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
64626  Destr paravertebrl nerve c/t                      A   3.92   7.49     8.15     3.04     3.66     0.34  11.75  12.41   7.30   7.92  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
64627  Destr paravertebral n add-on                      A   1.16   3.78     3.96     0.47     0.60     0.10   5.04   5.22   1.73   1.86  0ZZZ.00.00.0001100             25.5217 090 99      0.00   0.00   0.00
64630  Injection treatment of nerve                      A   3.05   3.26     3.16     2.15     2.16     0.34   6.65   6.55   5.54   5.55  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
64632  N block inj common digit                          A   1.23   1.17     1.17     0.75     0.72     0.10   2.50   2.50   2.08   2.05  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
64640  Injection treatment of nerve                      A   2.81   3.37     3.27     1.90     1.94     0.24   6.42   6.32   4.95   4.99  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
64650  Chemodenerv eccrine glands                        A   0.70   1.90     2.60     0.38     0.42     0.11   2.71   3.41   1.19   1.23  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
64653  Chemodenerv eccrine glands                        A   0.88   2.11     2.94     0.44     0.48     0.24   3.23   4.06   1.56   1.60  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
64680  Injection treatment of nerve                      A   2.67   6.29     6.47     1.84     2.03     0.30   9.26   9.44   4.81   5.00  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
64681  Injection treatment of nerve                      A   3.78   6.93     6.51     1.79     1.70     0.30  11.01  10.59   5.87   5.78  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
64702  Revise finger/toe nerve                           A   6.26   6.80NA   7.53NA   6.80     7.53     1.06  14.12  14.85  14.12  14.85  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64704  Revise hand/foot nerve                            A   4.69   4.25NA   4.33NA   4.25     4.33     0.54   9.48   9.56   9.48   9.56  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64708  Revise arm/leg nerve                              A   6.36   6.63NA   7.09NA   6.63     7.09     1.15  14.14  14.60  14.14  14.60  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64712  Revision of sciatic nerve                         A   8.07   6.71NA   7.25NA   6.71     7.25     1.33  16.11  16.65  16.11  16.65  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64713  Revision of arm nerve(s)                          A  11.40   8.55NA   9.05NA   8.55     9.05     2.34  22.29  22.79  22.29  22.79  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64714  Revise low back nerve(s)                          A  10.55   7.44NA   8.66NA   7.44     8.66     1.71  19.70  20.92  19.70  20.92  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64716  Revision of cranial nerve                         A   6.99   7.49NA   7.97NA   7.49     7.97     1.13  15.61  16.09  15.61  16.09  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64718  Revise ulnar nerve at elbow                       A   7.26   8.29NA   8.90NA   8.29     8.90     1.48  17.03  17.64  17.03  17.64  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
64719  Revise ulnar nerve at wrist                       A   4.97   5.64NA   5.98NA   5.64     5.98     0.92  11.53  11.87  11.53  11.87  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64721  Carpal tunnel surgery                             A   4.97   6.40     6.74     6.34     6.66     0.98  12.35  12.69  12.29  12.61  0090.11.76.1321100             25.5217 090 99      0.00   0.00   0.00
64722  Relieve pressure on nerve(s)                      A   4.82   4.41NA   4.82NA   4.41     4.82     0.84  10.07  10.48  10.07  10.48  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64726  Release foot/toe nerve                            A   4.27   3.47NA   3.57NA   3.47     3.57     0.39   8.13   8.23   8.13   8.23  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64727  Internal nerve revision                           A   3.10   1.77NA   1.89NA   1.77     1.89     0.60   5.47   5.59   5.47   5.59  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
64732  Incision of brow nerve                            A   4.89   5.65NA   6.32NA   5.65     6.32     1.77  12.31  12.98  12.31  12.98  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64734  Incision of cheek nerve                           A   5.55   6.18NA   7.15NA   6.18     7.15     0.71  12.44  13.41  12.44  13.41  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
64736  Incision of chin nerve                            A   5.23   5.58NA   5.97NA   5.58     5.97     1.87  12.68  13.07  12.68  13.07  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64738  Incision of jaw nerve                             A   6.36   6.56NA   7.60NA   6.56     7.60     2.27  15.19  16.23  15.19  16.23  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64740  Incision of tongue nerve                          A   6.22   6.49NA   7.01NA   6.49     7.01     0.80  13.51  14.03  13.51  14.03  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64742  Incision of facial nerve                          A   6.85   6.29NA   7.10NA   6.29     7.10     0.87  14.01  14.82  14.01  14.82  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64744  Incise nerve back of head                         A   5.72   5.77NA   6.79NA   5.77     6.79     2.04  13.53  14.55  13.53  14.55  0090.11.76.1321000             25.5217 090 99      0.00   0.00   0.00
64746  Incise diaphragm nerve                            A   6.56   4.88NA   4.78NA   4.88     4.78     1.53  12.97  12.87  12.97  12.87  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64752  Incision of vagus nerve                           A   7.69   5.68NA   6.06NA   5.68     6.06     1.81  15.18  15.56  15.18  15.56  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64755  Incision of stomach nerves                        A  15.05   8.28NA   9.12NA   8.28     9.12     3.20  26.53  27.37  26.53  27.37  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64760  Incision of vagus nerve                           A   7.59   5.34NA   6.01NA   5.34     6.01     1.60  14.53  15.20  14.53  15.20  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64761  Incision of pelvis nerve                          A   7.04   5.11NA   5.43NA   5.11     5.43     1.00  13.15  13.47  13.15  13.47  0090.11.76.1321200             25.5217 090 99      0.00   0.00   0.00
64763  Incise hip/thigh nerve                            A   7.56   6.31NA   5.90NA   6.31     5.90     1.60  15.47  15.06  15.47  15.06  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
64766  Incise hip/thigh nerve                            A   9.47   6.96NA   7.08NA   6.96     7.08     0.91  17.34  17.46  17.34  17.46  0090.11.76.1321200             25.5217 090 99      0.00   0.00   0.00
64771  Sever cranial nerve                               A   8.15   7.36NA   7.55NA   7.36     7.55     1.05  16.56  16.75  16.56  16.75  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64772  Incision of spinal nerve                          A   7.84   7.18NA   7.68NA   7.18     7.68     1.81  16.83  17.33  16.83  17.33  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64774  Remove skin nerve lesion                          A   5.80   5.27NA   5.64NA   5.27     5.64     1.05  12.12  12.49  12.12  12.49  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64776  Remove digit nerve lesion                         A   5.60   4.96NA   5.30NA   4.96     5.30     0.84  11.40  11.74  11.40  11.74  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
64778  Digit nerve surgery add-on                        A   3.11   1.93NA   2.25NA   1.93     2.25     0.61   5.65   5.97   5.65   5.97  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
64782  Remove limb nerve lesion                          A   6.86   5.45NA   5.76NA   5.45     5.76     0.91  13.22  13.53  13.22  13.53  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
64783  Limb nerve surgery add-on                         A   3.71   2.28NA   2.58NA   2.28     2.58     0.45   6.44   6.74   6.44   6.74  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
64784  Remove nerve lesion                               A  10.62   8.76NA   9.49NA   8.76     9.49     2.00  21.38  22.11  21.38  22.11  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
64786  Remove sciatic nerve lesion                       A  16.25  12.10NA  13.07NA  12.10    13.07     3.20  31.55  32.52  31.55  32.52  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64787  Implant nerve end                                 A   4.29   2.26NA   2.28NA   2.26     2.28     0.68   7.23   7.25   7.23   7.25  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
64788  Remove skin nerve lesion                          A   5.24   5.26NA   5.68NA   5.26     5.68     1.07  11.57  11.99  11.57  11.99  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64790  Removal of nerve lesion                           A  12.10   9.55NA  10.32NA   9.55    10.32     2.74  24.39  25.16  24.39  25.16  0090.11.76.1320010             25.5217 090 99      0.00   0.00   0.00
64792  Removal of nerve lesion                           A  15.86  11.77NA  12.21NA  11.77    12.21     5.68  33.31  33.75  33.31  33.75  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64795  Biopsy of nerve                                   A   3.01   2.00NA   2.15NA   2.00     2.15     0.81   5.82   5.97   5.82   5.97  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
64802  Remove sympathetic nerves                         A  10.37   6.90NA   8.86NA   6.90     8.86     0.81  18.08  20.04  18.08  20.04  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
64804  Remove sympathetic nerves                         A  15.91   6.83NA   6.62NA   6.83     6.62     1.26  24.00  23.79  24.00  23.79  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
64809  Remove sympathetic nerves                         A  14.71   9.09NA  10.82NA   9.09    10.82     1.17  24.97  26.70  24.97  26.70  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
64818  Remove sympathetic nerves                         A  11.34   6.22NA   6.76NA   6.22     6.76     2.06  19.62  20.16  19.62  20.16  0090.11.76.1321210             25.5217 090 99      0.00   0.00   0.00
64820  Remove sympathetic nerves                         A  10.74   9.66NA  10.51NA   9.66    10.51     1.90  22.30  23.15  22.30  23.15  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64821  Remove sympathetic nerves                         A   9.33   8.99NA   9.45NA   8.99     9.45     1.83  20.15  20.61  20.15  20.61  0090.11.76.1321100             25.5217 090 99      0.00   0.00   0.00
64822  Remove sympathetic nerves                         A   9.33   8.84NA   9.45NA   8.84     9.45     1.83  20.00  20.61  20.00  20.61  0090.11.76.1321100             25.5217 090 99      0.00   0.00   0.00
64823  Remove sympathetic nerves                         A  10.94   9.62NA  10.42NA   9.62    10.42     2.15  22.71  23.51  22.71  23.51  0090.11.76.1321100             25.5217 090 99      0.00   0.00   0.00
64831  Repair of digit nerve                             A   9.16   9.13NA   9.80NA   9.13     9.80     1.63  19.92  20.59  19.92  20.59  0090.11.76.1320100             25.5217 090 99      0.00   0.00   0.00
64832  Repair nerve add-on                               A   5.65   3.44NA   3.72NA   3.44     3.72     1.00  10.09  10.37  10.09  10.37  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
64834  Repair of hand or foot nerve                      A  10.81   9.11NA   9.80NA   9.11     9.80     1.85  21.77  22.46  21.77  22.46  0090.11.76.1320000             25.5217 090 99      0.00   0.00   0.00
64835  Repair of hand or foot nerve                      A  11.73   9.72NA  10.36NA   9.72    10.36     2.30  23.75  24.39  23.75  24.39  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64836  Repair of hand or foot nerve                      A  11.73   9.74NA  10.36NA   9.74    10.36     2.30  23.77  24.39  23.77  24.39  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64837  Repair nerve add-on                               A   6.25   3.63NA   3.74NA   3.63     3.74     0.76  10.64  10.75  10.64  10.75  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
64840  Repair of leg nerve                               A  14.02  10.60NA  11.22NA  10.60    11.22     1.07  25.69  26.31  25.69  26.31  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64856  Repair/transpose nerve                            A  15.07  11.91NA  12.79NA  11.91    12.79     2.84  29.82  30.70  29.82  30.70  0090.11.76.1320110             25.5217 090 99      0.00   0.00   0.00
64857  Repair arm/leg nerve                              A  15.82  12.31NA  13.16NA  12.31    13.16     2.91  31.04  31.89  31.04  31.89  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64858  Repair sciatic nerve                              A  17.82  14.50NA  15.92NA  14.50    15.92     3.50  35.82  37.24  35.82  37.24  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64859  Nerve surgery                                     A   4.25   2.72NA   3.07NA   2.72     3.07     0.83   7.80   8.15   7.80   8.15  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
64861  Repair of arm nerves                              A  20.89  12.94NA  12.46NA  12.94    12.46     4.11  37.94  37.46  37.94  37.46  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64862  Repair of low back nerves                         A  21.09  14.53NA  16.84NA  14.53    16.84     7.55  43.17  45.48  43.17  45.48  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64864  Repair of facial nerve                            A  13.41  10.36NA  11.13NA  10.36    11.13     1.70  25.47  26.24  25.47  26.24  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64865  Repair of facial nerve                            A  16.09  15.50NA  16.12NA  15.50    16.12     2.04  33.63  34.25  33.63  34.25  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64866  Fusion of facial/other nerve                      A  16.83  14.80NA  14.71NA  14.80    14.71     2.16  33.79  33.70  33.79  33.70  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64868  Fusion of facial/other nerve                      A  14.90  13.85NA  14.59NA  13.85    14.59     1.90  30.65  31.39  30.65  31.39  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64870  Fusion of facial/other nerve                      A  17.08  10.98NA  12.19NA  10.98    12.19     3.99  32.05  33.26  32.05  33.26  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64872  Subsequent repair of nerve                        A   1.99   1.16NA   1.19NA   1.16     1.19     0.26   3.41   3.44   3.41   3.44  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
64874  Repair & revise nerve add-on                      A   2.98   1.84NA   2.07NA   1.84     2.07     0.37   5.19   5.42   5.19   5.42  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
64876  Repair nerve/shorten bone                         A   3.37   1.74NA   1.88NA   1.74     1.88     0.65   5.76   5.90   5.76   5.90  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
64885  Nerve graft head or neck                          A  17.60  13.10NA  13.91NA  13.10    13.91     2.24  32.94  33.75  32.94  33.75  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64886  Nerve graft head or neck                          A  20.82  15.17NA  15.86NA  15.17    15.86     2.66  38.65  39.34  38.65  39.34  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64890  Nerve graft hand or foot                          A  16.24  12.45NA  13.06NA  12.45    13.06     3.19  31.88  32.49  31.88  32.49  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64891  Nerve graft hand or foot                          A  17.35  13.85NA  15.58NA  13.85    15.58     3.42  34.62  36.35  34.62  36.35  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64892  Nerve graft arm or leg                            A  15.74  12.08NA  12.76NA  12.08    12.76     3.11  30.93  31.61  30.93  31.61  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64893  Nerve graft arm or leg                            A  16.87  12.90NA  14.17NA  12.90    14.17     3.34  33.11  34.38  33.11  34.38  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64895  Nerve graft hand or foot                          A  20.39  15.53NA  17.77NA  15.53    17.77     4.01  39.93  42.17  39.93  42.17  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64896  Nerve graft hand or foot                          A  21.96  15.49NA  15.97NA  15.49    15.97     7.88  45.33  45.81  45.33  45.81  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64897  Nerve graft arm or leg                            A  19.38  14.41NA  15.58NA  14.41    15.58     3.82  37.61  38.78  37.61  38.78  0090.11.76.1320200             25.5217 090 99      0.00   0.00   0.00
64898  Nerve graft arm or leg                            A  20.97  15.49NA  16.34NA  15.49    16.34     4.13  40.59  41.44  40.59  41.44  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64901  Nerve graft add-on                                A  10.20   6.41NA   7.38NA   6.41     7.38     2.00  18.61  19.58  18.61  19.58  0ZZZ.00.00.0000210             25.5217 090 99      0.00   0.00   0.00
64902  Nerve graft add-on                                A  11.81   7.35NA   8.54NA   7.35     8.54     2.31  21.47  22.66  21.47  22.66  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
64905  Nerve pedicle transfer                            A  15.11  12.09NA  13.04NA  12.09    13.04     2.97  30.17  31.12  30.17  31.12  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64907  Nerve pedicle transfer                            A  20.03  12.44NA  11.02NA  12.44    11.02     1.41  33.88  32.46  33.88  32.46  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64910  Nerve repair w/allograft                          A  11.39  10.70NA  11.50NA  10.70    11.50     1.97  24.06  24.86  24.06  24.86  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64911  Neurorraphy w/vein autograft                      A  14.39  12.79NA  14.30NA  12.79    14.30     2.84  30.02  31.53  30.02  31.53  0090.11.76.1320210             25.5217 090 99      0.00   0.00   0.00
64999  Nervous system surgery                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
65091  Revise eye                                        A   7.26   9.69NA  10.44NA   9.69    10.44     1.44  18.39  19.14  18.39  19.14  0090.10.70.2021010             25.5217 090 99      0.00   0.00   0.00
65093  Revise eye with implant                           A   7.04   9.79NA  10.43NA   9.79    10.43     1.39  18.22  18.86  18.22  18.86  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65101  Removal of eye                                    A   8.30  11.37NA  12.26NA  11.37    12.26     1.63  21.30  22.19  21.30  22.19  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65103  Remove eye/insert implant                         A   8.84  11.68NA  12.64NA  11.68    12.64     1.74  22.26  23.22  22.26  23.22  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65105  Remove eye/attach implant                         A   9.93  12.68NA  13.77NA  12.68    13.77     1.94  24.55  25.64  24.55  25.64  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65110  Removal of eye                                    A  15.70  16.77NA  18.37NA  16.77    18.37     2.00  34.47  36.07  34.47  36.07  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65112  Remove eye/revise socket                          A  18.51  19.40NA  21.25NA  19.40    21.25     2.35  40.26  42.11  40.26  42.11  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65114  Remove eye/revise socket                          A  19.65  20.02NA  22.05NA  20.02    22.05     2.51  42.18  44.21  42.18  44.21  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65125  Revise ocular implant                             A   3.27   9.02     9.18     4.46     4.84     0.64  12.93  13.09   8.37   8.75  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65130  Insert ocular implant                             A   8.42  11.05NA  11.99NA  11.05    11.99     1.64  21.11  22.05  21.11  22.05  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65135  Insert ocular implant                             A   8.60  11.19NA  12.12NA  11.19    12.12     1.67  21.46  22.39  21.46  22.39  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65140  Attach ocular implant                             A   9.46  12.08NA  13.08NA  12.08    13.08     1.22  22.76  23.76  22.76  23.76  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65150  Revise ocular implant                             A   6.43   9.06NA   9.65NA   9.06     9.65     0.45  15.94  16.53  15.94  16.53  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
65155  Reinsert ocular implant                           A  10.10  12.49NA  13.53NA  12.49    13.53     1.97  24.56  25.60  24.56  25.60  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65175  Removal of ocular implant                         A   7.40  10.14NA  10.94NA  10.14    10.94     0.95  18.49  19.29  18.49  19.29  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65205  Remove foreign body from eye                      A   0.71   0.77     0.82     0.45     0.51     0.10   1.58   1.63   1.26   1.32  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
65210  Remove foreign body from eye                      A   0.84   1.01     1.09     0.58     0.67     0.12   1.97   2.05   1.54   1.63  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
65220  Remove foreign body from eye                      A   0.71   0.81     0.87     0.41     0.46     0.11   1.63   1.69   1.23   1.28  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
65222  Remove foreign body from eye                      A   0.93   1.10     1.18     0.62     0.71     0.14   2.17   2.25   1.69   1.78  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
65235  Remove foreign body from eye                      A   9.01   9.78NA  10.96NA   9.78    10.96     1.24  20.03  21.21  20.03  21.21  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
65260  Remove foreign body from eye                      A  12.54  12.90NA  14.38NA  12.90    14.38     0.88  26.32  27.80  26.32  27.80  0090.10.70.2021200             25.5217 090 99      0.00   0.00   0.00
65265  Remove foreign body from eye                      A  14.34  14.29NA  15.98NA  14.29    15.98     3.07  31.70  33.39  31.70  33.39  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65270  Repair of eye wound                               A   1.95   5.23     5.32     1.79     1.99     0.27   7.45   7.54   4.01   4.21  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
65272  Repair of eye wound                               A   4.62   8.79     9.27     4.68     5.26     0.33  13.74  14.22   9.63  10.21  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65273  Repair of eye wound                               A   5.16   4.97NA   5.57NA   4.97     5.57     0.37  10.50  11.10  10.50  11.10  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65275  Repair of eye wound                               A   6.29   8.87     9.82     5.87     6.74     0.86  16.02  16.97  13.02  13.89  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
65280  Repair of eye wound                               A   9.10   8.63NA   9.66NA   8.63     9.66     1.79  19.52  20.55  19.52  20.55  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
65285  Repair of eye wound                               A  14.71  12.79NA  14.50NA  12.79    14.50     2.59  30.09  31.80  30.09  31.80  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65286  Repair of eye wound                               A   6.63  12.24    12.85     6.50     7.32     0.90  19.77  20.38  14.03  14.85  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65290  Repair of eye socket wound                        A   6.53   6.52NA   7.28NA   6.52     7.28     1.28  14.33  15.09  14.33  15.09  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65400  Removal of eye lesion                             A   7.50  10.54    11.46     8.46     9.42     1.03  19.07  19.99  16.99  17.95  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65410  Biopsy of cornea                                  A   1.47   2.36     2.49     1.30     1.47     0.31   4.14   4.27   3.08   3.25  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
65420  Removal of eye lesion                             A   4.36   9.50     9.87     5.66     6.19     0.56  14.42  14.79  10.58  11.11  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65426  Removal of eye lesion                             A   6.05  11.41    12.00     6.65     7.39     0.83  18.29  18.88  13.53  14.27  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65430  Corneal smear                                     A   1.47   1.59     1.73     1.29     1.44     0.22   3.28   3.42   2.98   3.13  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
65435  Curette/treat cornea                              A   0.92   1.22     1.31     0.94     1.04     0.16   2.30   2.39   2.02   2.12  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
65436  Curette/treat cornea                              A   4.82   5.46     6.04     5.03     5.62     0.84  11.12  11.70  10.69  11.28  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65450  Treatment of corneal lesion                       A   3.47   5.16     5.59     5.06     5.50     0.48   9.11   9.54   9.01   9.45  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65600  Revision of cornea                                A   4.20   6.28     6.80     4.88     5.47     0.60  11.08  11.60   9.68  10.27  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65710  Corneal transplant                                A  14.45  14.98NA  16.70NA  14.98    16.70     1.97  31.40  33.12  31.40  33.12  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65730  Corneal transplant                                A  16.35  16.28NA  18.22NA  16.28    18.22     2.23  34.86  36.80  34.86  36.80  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65750  Corneal transplant                                A  16.90  15.96NA  17.89NA  15.96    17.89     2.16  35.02  36.95  35.02  36.95  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65755  Corneal transplant                                A  16.79  15.89NA  17.81NA  15.89    17.81     2.28  34.96  36.88  34.96  36.88  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65756  Corneal trnspl endothelial                        A  16.84  14.56NA  16.58NA  14.56    16.58     1.20  32.60  34.62  32.60  34.62  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65757  Prep corneal endo allograft                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
65760  Revision of cornea                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
65765  Revision of cornea                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
65767  Corneal tissue transplant                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
65770  Revise cornea with implant                        A  19.74  17.68NA  19.87NA  17.68    19.87     7.06  44.48  46.67  44.48  46.67  0090.10.70.2021200             25.5217 090 99      0.00   0.00   0.00
65771  Radial keratotomy                                 N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
65772  Correction of astigmatism                         A   5.09   6.91     7.51     5.68     6.32     0.65  12.65  13.25  11.42  12.06  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65775  Correction of astigmatism                         A   6.91   7.77NA   8.58NA   7.77     8.58     0.49  15.17  15.98  15.17  15.98  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65778  Cover eye w/membrane                              A   1.19  35.71    35.71     0.84     0.84     0.18  37.08  37.08   2.21   2.21  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
65779  Cover eye w/membrane stent                        A   3.92  29.05    29.05     4.09     4.09     0.56  33.53  33.53   8.57   8.57  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
65780  Ocular reconst transplant                         A  10.73  12.94NA  14.18NA  12.94    14.18     1.39  25.06  26.30  25.06  26.30  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65781  Ocular reconst transplant                         A  18.14  17.46NA  19.44NA  17.46    19.44     1.28  36.88  38.86  36.88  38.86  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
65782  Ocular reconst transplant                         A  15.43  15.29NA  16.99NA  15.29    16.99     3.06  33.78  35.48  33.78  35.48  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65800  Drainage of eye                                   A   1.91   2.07     2.25     1.57     1.77     0.27   4.25   4.43   3.75   3.95  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
65805  Drainage of eye                                   A   1.91   2.47     2.64     1.58     1.78     0.34   4.72   4.89   3.83   4.03  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
65810  Drainage of eye                                   A   5.82   6.70NA   7.46NA   6.70     7.46     0.84  13.36  14.12  13.36  14.12  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65815  Drainage of eye                                   A   6.00  11.08    11.65     6.65     7.40     1.06  18.14  18.71  13.71  14.46  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65820  Relieve inner eye pressure                        A   8.91  11.04NA  12.03NA  11.04    12.03     0.62  20.57  21.56  20.57  21.56  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
65850  Incision of eye                                   A  11.39  10.99NA  12.25NA  10.99    12.25     1.98  24.36  25.62  24.36  25.62  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65855  Laser surgery of eye                              A   3.99   5.07     5.48     3.95     4.38     0.62   9.68  10.09   8.56   8.99  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
65860  Incise inner eye adhesions                        A   3.59   4.70     5.06     3.18     3.55     1.32   9.61   9.97   8.09   8.46  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
65865  Incise inner eye adhesions                        A   5.77   6.85NA   7.47NA   6.85     7.47     0.39  13.01  13.63  13.01  13.63  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65870  Incise inner eye adhesions                        A   7.39   8.32NA   9.19NA   8.32     9.19     1.29  17.00  17.87  17.00  17.87  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65875  Incise inner eye adhesions                        A   7.81   8.93NA   9.86NA   8.93     9.86     1.07  17.81  18.74  17.81  18.74  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65880  Incise inner eye adhesions                        A   8.36   9.24NA  10.25NA   9.24    10.25     0.60  18.20  19.21  18.20  19.21  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
65900  Remove eye lesion                                 A  12.51  13.14NA  14.58NA  13.14    14.58     0.88  26.53  27.97  26.53  27.97  0090.10.70.2021200             25.5217 090 99      0.00   0.00   0.00
65920  Remove implant of eye                             A   9.99  10.93NA  12.14NA  10.93    12.14     1.29  22.21  23.42  22.21  23.42  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
65930  Remove blood clot from eye                        A   8.39   8.60NA   9.52NA   8.60     9.52     1.48  18.47  19.39  18.47  19.39  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
66020  Injection treatment of eye                        A   1.64   3.37     3.51     1.86     2.05     0.11   5.12   5.26   3.61   3.80  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
66030  Injection treatment of eye                        A   1.30   3.16     3.27     1.65     1.81     0.18   4.64   4.75   3.13   3.29  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
66130  Remove eye lesion                                 A   7.83  10.85    11.58     7.34     8.20     1.66  20.34  21.07  16.83  17.69  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
66150  Glaucoma surgery                                  A  10.53  12.69NA  14.03NA  12.69    14.03     0.73  23.95  25.29  23.95  25.29  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
66155  Glaucoma surgery                                  A  10.52  12.67NA  14.02NA  12.67    14.02     0.73  23.92  25.27  23.92  25.27  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66160  Glaucoma surgery                                  A  12.39  13.81NA  15.34NA  13.81    15.34     0.87  27.07  28.60  27.07  28.60  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
66165  Glaucoma surgery                                  A  10.24  12.50NA  13.83NA  12.50    13.83     0.72  23.46  24.79  23.46  24.79  0090.10.70.2021200             25.5217 090 99      0.00   0.00   0.00
66170  Glaucoma surgery                                  A  15.02  16.78NA  18.68NA  16.78    18.68     1.91  33.71  35.61  33.71  35.61  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
66172  Incision of eye                                   A  18.86  21.22NA  23.66NA  21.22    23.66     2.40  42.48  44.92  42.48  44.92  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
66174  Translum dil eye canal                            A  12.85  13.84NA  13.84NA  13.84    13.84     2.27  28.96  28.96  28.96  28.96  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
66175  Trnslum dil eye canal w/stnt                      A  13.60  14.37NA  14.37NA  14.37    14.37     4.86  32.83  32.83  32.83  32.83  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
66180  Implant eye shunt                                 A  16.30  14.67NA  16.55NA  14.67    16.55     2.12  33.09  34.97  33.09  34.97  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
66185  Revise eye shunt                                  A   9.58  10.28NA  11.48NA  10.28    11.48     1.67  21.53  22.73  21.53  22.73  0090.10.70.2021200             25.5217 090 99      0.00   0.00   0.00
66220  Repair eye lesion                                 A   9.21  10.36NA  11.66NA  10.36    11.66     1.26  20.83  22.13  20.83  22.13  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
66225  Repair/graft eye lesion                           A  12.63  12.09NA  13.59NA  12.09    13.59     2.47  27.19  28.69  27.19  28.69  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
66250  Follow-up surgery of eye                          A   7.10  12.96    13.63     7.65     8.55     1.40  21.46  22.13  16.15  17.05  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66500  Incision of iris                                  A   3.83   5.60NA   6.03NA   5.60     6.03     0.27   9.70  10.13   9.70  10.13  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
66505  Incision of iris                                  A   4.22   6.10NA   6.58NA   6.10     6.58     0.30  10.62  11.10  10.62  11.10  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66600  Remove iris and lesion                            A  10.12  11.84NA  13.19NA  11.84    13.19     0.76  22.72  24.07  22.72  24.07  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66605  Removal of iris                                   A  14.22  13.78NA  15.54NA  13.78    15.54     1.02  29.02  30.78  29.02  30.78  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66625  Removal of iris                                   A   5.30   6.11NA   6.74NA   6.11     6.74     0.72  12.13  12.76  12.13  12.76  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66630  Removal of iris                                   A   7.28   7.82NA   8.72NA   7.82     8.72     1.22  16.32  17.22  16.32  17.22  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66635  Removal of iris                                   A   7.37   7.87NA   8.78NA   7.87     8.78     0.52  15.76  16.67  15.76  16.67  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66680  Repair iris & ciliary body                        A   6.39   7.29NA   8.10NA   7.29     8.10     1.36  15.04  15.85  15.04  15.85  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
66682  Repair iris & ciliary body                        A   7.33   9.45NA  10.47NA   9.45    10.47     1.45  18.23  19.25  18.23  19.25  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66700  Destruction ciliary body                          A   5.14   6.82     7.44     5.30     5.92     0.49  12.45  13.07  10.93  11.55  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
66710  Ciliary transsleral therapy                       A   5.14   6.59     7.19     5.29     5.91     1.02  12.75  13.35  11.45  12.07  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66711  Ciliary endoscopic ablation                       A   7.93   9.09NA  10.12NA   9.09    10.12     0.56  17.58  18.61  17.58  18.61  0090.10.70.2031100       66710 25.5217 090 99      0.00   0.00   0.00
66720  Destruction ciliary body                          A   5.00   7.49     8.16     6.17     6.80     0.68  13.17  13.84  11.85  12.48  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66740  Destruction ciliary body                          A   5.14   6.49     7.09     5.32     5.92     0.35  11.98  12.58  10.81  11.41  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66761  Revision of iris                                  A   3.00   5.85     5.25     4.46     3.63     0.45   9.30   8.70   7.91   7.08  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
66762  Revision of iris                                  A   5.38   7.25     7.91     5.91     6.59     0.68  13.31  13.97  11.97  12.65  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66770  Removal of inner eye lesion                       A   6.13   7.89     8.63     6.67     7.43     0.42  14.44  15.18  13.22  13.98  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66820  Incision secondary cataract                       A   4.01   6.54NA   6.91NA   6.54     6.91     0.67  11.22  11.59  11.22  11.59  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66821  After cataract laser surgery                      A   3.42   5.33     5.77     4.81     5.26     0.53   9.28   9.72   8.76   9.21  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66825  Reposition intraocular lens                       A   9.01  11.23NA  12.23NA  11.23    12.23     1.17  21.41  22.41  21.41  22.41  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
66830  Removal of lens lesion                            A   9.47   9.46NA  10.60NA   9.46    10.60     0.67  19.60  20.74  19.60  20.74  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66840  Removal of lens material                          A   9.18   9.28NA  10.41NA   9.28    10.41     1.81  20.27  21.40  20.27  21.40  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66850  Removal of lens material                          A  10.55  10.48NA  11.75NA  10.48    11.75     1.45  22.48  23.75  22.48  23.75  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66852  Removal of lens material                          A  11.41  11.03NA  12.37NA  11.03    12.37     2.00  24.44  25.78  24.44  25.78  0090.10.70.2021010             25.5217 090 99      0.00   0.00   0.00
66920  Extraction of lens                                A  10.13   9.90NA  11.10NA   9.90    11.10     0.71  20.74  21.94  20.74  21.94  0090.10.70.2021010             25.5217 090 99      0.00   0.00   0.00
66930  Extraction of lens                                A  11.61  11.15NA  12.52NA  11.15    12.52     0.81  23.57  24.94  23.57  24.94  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
66940  Extraction of lens                                A  10.37  10.38NA  11.62NA  10.38    11.62     1.74  22.49  23.73  22.49  23.73  0090.10.70.2021010             25.5217 090 99      0.00   0.00   0.00
66982  Cataract surgery complex                          A  15.02  13.07NA  14.70NA  13.07    14.70     2.32  30.41  32.04  30.41  32.04  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66983  Cataract surg w/iol 1 stage                       A  10.43   9.28NA  10.41NA   9.28    10.41     0.83  20.54  21.67  20.54  21.67  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66984  Cataract surg w/iol 1 stage                       A  10.52   9.72NA  10.85NA   9.72    10.85     1.64  21.88  23.01  21.88  23.01  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
66985  Insert lens prosthesis                            A   9.98  10.43NA  11.68NA  10.43    11.68     1.29  21.70  22.95  21.70  22.95  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
66986  Exchange lens prosthesis                          A  12.26  11.99NA  13.32NA  11.99    13.32     1.56  25.81  27.14  25.81  27.14  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
66990  Ophthalmic endoscope add-on                       A   1.51   0.91NA   1.06NA   0.91     1.06     0.10   2.52   2.67   2.52   2.67  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
66999  Eye surgery procedure                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
67005  Partial removal of eye fluid                      A   5.89   6.63NA   7.36NA   6.63     7.36     1.25  13.77  14.50  13.77  14.50  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67010  Partial removal of eye fluid                      A   7.06   7.34NA   8.18NA   7.34     8.18     0.98  15.38  16.22  15.38  16.22  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67015  Release of eye fluid                              A   7.14   8.28NA   9.11NA   8.28     9.11     0.99  16.41  17.24  16.41  17.24  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67025  Replace eye fluid                                 A   8.11  11.23    12.14     8.64     9.66     1.44  20.78  21.69  18.19  19.21  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67027  Implant eye drug system                           A  11.62  10.97NA  12.31NA  10.97    12.31     2.02  24.61  25.95  24.61  25.95  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67028  Injection eye drug                                A   1.44   2.15     1.43     1.52     1.38     0.20   3.79   3.07   3.16   3.02  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
67030  Incise inner eye strands                          A   6.11   7.96NA   8.77NA   7.96     8.77     0.42  14.49  15.30  14.49  15.30  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67031  Laser surgery eye strands                         A   4.47   5.86     6.39     4.98     5.55     0.58  10.91  11.44  10.03  10.60  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67036  Removal of inner eye fluid                        A  13.32  12.20NA  13.71NA  12.20    13.71     1.82  27.34  28.85  27.34  28.85  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67039  Laser treatment of retina                         A  16.74  16.08NA  17.98NA  16.08    17.98     2.96  35.78  37.68  35.78  37.68  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67040  Laser treatment of retina                         A  19.61  18.17NA  20.40NA  18.17    20.40     2.69  40.47  42.70  40.47  42.70  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67041  Vit for macular pucker                            A  19.25  15.87NA  18.16NA  15.87    18.16     2.63  37.75  40.04  37.75  40.04  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67042  Vit for macular hole                              A  22.38  17.73NA  20.37NA  17.73    20.37     3.08  43.19  45.83  43.19  45.83  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67043  Vit for membrane dissect                          A  23.24  18.94NA  21.69NA  18.94    21.69     4.09  46.27  49.02  46.27  49.02  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67101  Repair detached retina                            A   8.80  12.00    13.11     9.07    10.16     1.55  22.35  23.46  19.42  20.51  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67105  Repair detached retina                            A   8.53  10.62    11.66     8.55     9.59     1.17  20.32  21.36  18.25  19.29  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67107  Repair detached retina                            A  16.71  15.56NA  17.54NA  15.56    17.54     2.95  35.22  37.20  35.22  37.20  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67108  Repair detached retina                            A  22.89  19.77NA  22.40NA  19.77    22.40     3.14  45.80  48.43  45.80  48.43  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67110  Repair detached retina                            A  10.25  12.87    14.05    10.29    11.55     1.30  24.42  25.60  21.84  23.10  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67112  Rerepair detached retina                          A  18.75  16.47NA  18.65NA  16.47    18.65     2.57  37.79  39.97  37.79  39.97  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67113  Repair retinal detach cplx                        A  25.35  20.91NA  23.92NA  20.91    23.92     3.48  49.74  52.75  49.74  52.75  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67115  Release encircling material                       A   6.11   7.10NA   7.89NA   7.10     7.89     0.77  13.98  14.77  13.98  14.77  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67120  Remove eye implant material                       A   7.10  10.42    11.23     7.70     8.59     1.40  18.92  19.73  16.20  17.09  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67121  Remove eye implant material                       A  12.25  11.85NA  13.34NA  11.85    13.34     2.16  26.26  27.75  26.26  27.75  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67141  Treatment of retina                               A   6.15   7.74     8.51     6.76     7.54     1.09  14.98  15.75  14.00  14.78  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67145  Treatment of retina                               A   6.32   7.67     8.46     6.86     7.66     0.86  14.85  15.64  14.04  14.84  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67208  Treatment of retinal lesion                       A   7.65   8.26     9.18     7.68     8.61     0.53  16.44  17.36  15.86  16.79  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67210  Treatment of retinal lesion                       A   9.45   8.87     9.96     8.24     9.34     1.40  19.72  20.81  19.09  20.19  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67218  Treatment of retinal lesion                       A  20.36  16.48NA  18.72NA  16.48    18.72     1.45  38.29  40.53  38.29  40.53  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67220  Treatment of choroid lesion                       A  14.39  13.82    15.45    12.44    14.10     2.54  30.75  32.38  29.37  31.03  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67221  Ocular photodynamic ther                          R   3.45   4.35     4.58     2.29     2.62     0.48   8.28   8.51   6.22   6.55  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
67225  Eye photodynamic ther add-on                      A   0.47   0.33     0.38     0.28     0.33     0.03   0.83   0.88   0.78   0.83  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
67227  Treatment of retinal lesion                       A   7.53   8.69     9.59     7.61     8.53     0.53  16.75  17.65  15.67  16.59  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67228  Treatment of retinal lesion                       A  13.82  17.49    18.53    14.24    16.01     2.09  33.40  34.44  30.15  31.92  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67229  Tr retinal les preterm inf                        A  16.30  13.98NA  15.61NA  13.98    15.61     1.17  31.45  33.08  31.45  33.08  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67250  Reinforce eye wall                                A   9.61  11.22NA  12.25NA  11.22    12.25     1.62  22.45  23.48  22.45  23.48  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67255  Reinforce/graft eye wall                          A  10.17  12.25NA  13.37NA  12.25    13.37     1.98  24.40  25.52  24.40  25.52  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67299  Eye surgery procedure                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
67311  Revise eye muscle                                 A   7.77   8.11NA   9.04NA   8.11     9.04     1.30  17.18  18.11  17.18  18.11  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67312  Revise two eye muscles                            A   9.66   9.23NA  10.36NA   9.23    10.36     1.90  20.79  21.92  20.79  21.92  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67314  Revise eye muscle                                 A   8.79   9.05NA  10.12NA   9.05    10.12     1.48  19.32  20.39  19.32  20.39  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67316  Revise two eye muscles                            A  10.93  10.29NA  11.59NA  10.29    11.59     2.15  23.37  24.67  23.37  24.67  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
67318  Revise eye muscle(s)                              A   9.12   9.57NA  10.71NA   9.57    10.71     0.64  19.33  20.47  19.33  20.47  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67320  Revise eye muscle(s) add-on                       A   5.40   3.18NA   3.78NA   3.18     3.78     0.38   8.96   9.56   8.96   9.56  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
67331  Eye surgery follow-up add-on                      A   5.13   2.99NA   3.56NA   2.99     3.56     0.86   8.98   9.55   8.98   9.55  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
67332  Rerevise eye muscles add-on                       A   5.56   3.28NA   3.90NA   3.28     3.90     0.92   9.76  10.38   9.76  10.38  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
67334  Revise eye muscle w/suture                        A   5.05   2.98NA   3.56NA   2.98     3.56     0.35   8.38   8.96   8.38   8.96  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
67335  Eye suture during surgery                         A   2.49   1.50NA   1.74NA   1.50     1.74     0.41   4.40   4.64   4.40   4.64  0ZZZ.00.00.0000110             25.5217 090 99      0.00   0.00   0.00
67340  Revise eye muscle add-on                          A   6.00   3.55NA   4.23NA   3.55     4.23     0.42   9.97  10.65   9.97  10.65  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
67343  Release eye tissue                                A   8.47   8.86NA   9.88NA   8.86     9.88     1.66  18.99  20.01  18.99  20.01  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67345  Destroy nerve of eye muscle                       A   3.01   3.22     3.57     2.60     2.93     0.80   7.03   7.38   6.41   6.74  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67346  Biopsy eye muscle                                 A   2.87   2.48NA   2.79NA   2.48     2.79     0.61   5.96   6.27   5.96   6.27  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
67399  Eye muscle surgery procedure                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021211             25.5217 090 99      0.00   0.00   0.00
67400  Explore/biopsy eye socket                         A  11.20  13.64NA  14.82NA  13.64    14.82     2.06  26.90  28.08  26.90  28.08  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67405  Explore/drain eye socket                          A   9.20  12.00NA  12.95NA  12.00    12.95     1.18  22.38  23.33  22.38  23.33  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67412  Explore/treat eye socket                          A  10.30  12.52NA  13.50NA  12.52    13.50     1.86  24.68  25.66  24.68  25.66  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67413  Explore/treat eye socket                          A  10.24  12.65NA  13.65NA  12.65    13.65     2.00  24.89  25.89  24.89  25.89  0090.10.70.2021200             25.5217 090 99      0.00   0.00   0.00
67414  Explr/decompress eye socket                       A  17.94  17.20NA  19.33NA  17.20    19.33     2.28  37.42  39.55  37.42  39.55  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67415  Aspiration orbital contents                       A   1.76   1.05NA   1.24NA   1.05     1.24     0.24   3.05   3.24   3.05   3.24  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
67420  Explore/treat eye socket                          A  21.87  21.38NA  23.61NA  21.38    23.61     4.30  47.55  49.78  47.55  49.78  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67430  Explore/treat eye socket                          A  15.29  17.99NA  19.61NA  17.99    19.61     1.09  34.37  35.99  34.37  35.99  0090.10.70.2021200             25.5217 090 99      0.00   0.00   0.00
67440  Explore/drain eye socket                          A  14.84  17.33NA  18.92NA  17.33    18.92     1.90  34.07  35.66  34.07  35.66  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67445  Explr/decompress eye socket                       A  19.12  18.22NA  20.30NA  18.22    20.30     3.76  41.10  43.18  41.10  43.18  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67450  Explore/biopsy eye socket                         A  15.41  18.04NA  19.69NA  18.04    19.69     1.97  35.42  37.07  35.42  37.07  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67500  Inject/treat eye socket                           A   1.44   0.83     0.89     0.62     0.71     0.11   2.38   2.44   2.17   2.26  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
67505  Inject/treat eye socket                           A   1.27   1.09     1.25     0.86     1.04     0.26   2.62   2.78   2.39   2.57  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
67515  Inject/treat eye socket                           A   1.40   1.14     1.34     0.93     1.13     0.26   2.80   3.00   2.59   2.79  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
67550  Insert eye socket implant                         A  11.77  14.01NA  15.24NA  14.01    15.24     2.30  28.08  29.31  28.08  29.31  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67560  Revise eye socket implant                         A  12.18  14.21NA  15.56NA  14.21    15.56     1.56  27.95  29.30  27.95  29.30  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
67570  Decompress optic nerve                            A  14.40  16.18NA  17.46NA  16.18    17.46     5.15  35.73  37.01  35.73  37.01  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67599  Orbit surgery procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021211             25.5217 090 99      0.00   0.00   0.00
67700  Drainage of eyelid abscess                        A   1.40   5.85     5.86     1.68     1.85     0.23   7.48   7.49   3.31   3.48  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67710  Incision of eyelid                                A   1.07   5.03     4.99     1.52     1.65     0.22   6.32   6.28   2.81   2.94  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67715  Incision of eyelid fold                           A   1.27   5.16     5.16     1.63     1.78     0.26   6.69   6.69   3.16   3.31  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67800  Remove eyelid lesion                              A   1.41   1.98     2.13     1.35     1.50     0.24   3.63   3.78   3.00   3.15  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
67801  Remove eyelid lesions                             A   1.91   2.41     2.62     1.65     1.86     0.37   4.69   4.90   3.93   4.14  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
67805  Remove eyelid lesions                             A   2.27   3.11     3.36     2.13     2.38     0.43   5.81   6.06   4.83   5.08  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
67808  Remove eyelid lesion(s)                           A   4.60   5.17NA   5.74NA   5.17     5.74     0.90  10.67  11.24  10.67  11.24  0090.10.70.2020100             25.5217 090 99      0.00   0.00   0.00
67810  Biopsy of eyelid                                  A   1.48   4.58     4.53     0.98     1.08     0.22   6.28   6.23   2.68   2.78  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
67820  Revise eyelashes                                  A   0.71   0.65     0.70     0.72     0.79     0.11   1.47   1.52   1.54   1.61  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
67825  Revise eyelashes                                  A   1.43   2.00     2.15     1.81     1.97     0.27   3.70   3.85   3.51   3.67  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67830  Revise eyelashes                                  A   1.75   5.46     5.53     1.93     2.13     0.34   7.55   7.62   4.02   4.22  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67835  Revise eyelashes                                  A   5.70   5.99NA   6.63NA   5.99     6.63     1.13  12.82  13.46  12.82  13.46  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
67840  Remove eyelid lesion                              A   2.09   5.39     5.47     2.14     2.37     0.34   7.82   7.90   4.57   4.80  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67850  Treat eyelid lesion                               A   1.74   4.24     4.25     2.00     2.11     0.24   6.22   6.23   3.98   4.09  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67875  Closure of eyelid by suture                       A   1.35   3.30     3.36     1.24     1.39     0.24   4.89   4.95   2.83   2.98  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
67880  Revision of eyelid                                A   4.60   7.64     8.12     5.17     5.74     0.81  13.05  13.53  10.58  11.15  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67882  Revision of eyelid                                A   6.02   9.02     9.67     6.52     7.25     1.18  16.22  16.87  13.72  14.45  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67900  Repair brow defect                                A   6.82  10.37    11.01     6.79     7.51     1.22  18.41  19.05  14.83  15.55  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67901  Repair eyelid defect                              A   7.59  11.74    13.34     7.68     8.60     1.49  20.82  22.42  16.76  17.68  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67902  Repair eyelid defect                              A   9.82   9.24NA  10.59NA   9.24    10.59     1.93  20.99  22.34  20.99  22.34  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67903  Repair eyelid defect                              A   6.51   9.61    10.03     6.50     7.12     1.26  17.38  17.80  14.27  14.89  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67904  Repair eyelid defect                              A   7.97  11.55    12.41     7.83     8.85     1.52  21.04  21.90  17.32  18.34  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67906  Repair eyelid defect                              A   6.93   6.63NA   7.39NA   6.63     7.39     0.49  14.05  14.81  14.05  14.81  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67908  Repair eyelid defect                              A   5.30   7.88     8.45     6.12     6.62     1.05  14.23  14.80  12.47  12.97  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67909  Revise eyelid defect                              A   5.57   8.80     9.29     6.13     6.72     1.10  15.47  15.96  12.80  13.39  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67911  Revise eyelid defect                              A   7.50   7.34NA   8.32NA   7.34     8.32     1.40  16.24  17.22  16.24  17.22  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67912  Correction eyelid w/implant                       A   6.36  18.00    18.05     6.85     7.48     0.92  25.28  25.33  14.13  14.76  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67914  Repair eyelid defect                              A   3.75   6.70     6.98     3.94     4.35     0.68  11.13  11.41   8.37   8.78  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67915  Repair eyelid defect                              A   3.26   6.08     6.28     3.53     3.86     0.45   9.79   9.99   7.24   7.57  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67916  Repair eyelid defect                              A   5.48   8.97     9.47     6.05     6.65     0.95  15.40  15.90  12.48  13.08  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67917  Repair eyelid defect                              A   6.19   9.53    10.10     6.49     7.16     1.15  16.87  17.44  13.83  14.50  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67921  Repair eyelid defect                              A   3.47   6.50     6.77     3.75     4.14     0.68  10.65  10.92   7.90   8.29  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67922  Repair eyelid defect                              A   3.14   5.91     6.09     3.40     3.71     0.42   9.47   9.65   6.96   7.27  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67923  Repair eyelid defect                              A   6.05   9.16     9.74     6.38     7.05     1.13  16.34  16.92  13.56  14.23  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67924  Repair eyelid defect                              A   5.93   9.80    10.32     6.03     6.69     1.13  16.86  17.38  13.09  13.75  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67930  Repair eyelid wound                               A   3.65   6.18     6.47     2.80     3.16     0.71  10.54  10.83   7.16   7.52  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67935  Repair eyelid wound                               A   6.36   9.59    10.18     5.50     6.14     1.25  17.20  17.79  13.11  13.75  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67938  Remove eyelid foreign body                        A   1.38   5.23     5.25     1.71     1.87     0.22   6.83   6.85   3.31   3.47  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
67950  Revision of eyelid                                A   5.99   9.43     9.94     6.42     7.04     1.10  16.52  17.03  13.51  14.13  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67961  Revision of eyelid                                A   5.86   9.60    10.12     6.31     6.93     1.10  16.56  17.08  13.27  13.89  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
67966  Revision of eyelid                                A   8.97  11.49    12.50     8.43     9.56     1.70  22.16  23.17  19.10  20.23  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67971  Reconstruction of eyelid                          A  10.01   9.33NA  10.40NA   9.33    10.40     1.96  21.30  22.37  21.30  22.37  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
67973  Reconstruction of eyelid                          A  13.13  11.80NA  13.16NA  11.80    13.16     2.58  27.51  28.87  27.51  28.87  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67974  Reconstruction of eyelid                          A  13.10  11.75NA  13.13NA  11.75    13.13     2.58  27.43  28.81  27.43  28.81  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
67975  Reconstruction of eyelid                          A   9.35   8.95NA   9.96NA   8.95     9.96     1.83  20.13  21.14  20.13  21.14  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
67999  Revision of eyelid                                C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
68020  Incise/drain eyelid lining                        A   1.42   1.77     1.92     1.53     1.69     0.20   3.39   3.54   3.15   3.31  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68040  Treatment of eyelid lesions                       A   0.85   0.89     0.97     0.57     0.65     0.16   1.90   1.98   1.58   1.66  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
68100  Biopsy of eyelid lining                           A   1.35   3.25     3.30     1.27     1.41     0.20   4.80   4.85   2.82   2.96  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
68110  Remove eyelid lining lesion                       A   1.82   4.25     4.38     2.14     2.35     0.35   6.42   6.55   4.31   4.52  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68115  Remove eyelid lining lesion                       A   2.41   5.99     6.13     2.49     2.76     0.31   8.71   8.85   5.21   5.48  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68130  Remove eyelid lining lesion                       A   5.10   9.37     9.81     5.88     6.47     0.35  14.82  15.26  11.33  11.92  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
68135  Remove eyelid lining lesion                       A   1.89   2.28     2.49     2.13     2.34     0.26   4.43   4.64   4.28   4.49  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68200  Treat eyelid by injection                         A   0.49   0.64     0.69     0.44     0.49     0.08   1.21   1.26   1.01   1.06  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
68320  Revise/graft eyelid lining                        A   6.64  12.75    13.42     7.65     8.50     1.29  20.68  21.35  15.58  16.43  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
68325  Revise/graft eyelid lining                        A   8.63   8.88NA   9.91NA   8.88     9.91     1.68  19.19  20.22  19.19  20.22  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
68326  Revise/graft eyelid lining                        A   8.42   8.72NA   9.75NA   8.72     9.75     1.64  18.78  19.81  18.78  19.81  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
68328  Revise/graft eyelid lining                        A   9.45   9.48NA  10.57NA   9.48    10.57     1.86  20.79  21.88  20.79  21.88  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
68330  Revise eyelid lining                              A   5.78  10.40    10.95     6.45     7.17     1.14  17.32  17.87  13.37  14.09  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
68335  Revise/graft eyelid lining                        A   8.46   8.72NA   9.74NA   8.72     9.74     1.66  18.84  19.86  18.84  19.86  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
68340  Separate eyelid adhesions                         A   4.97   9.62    10.07     5.60     6.23     0.99  15.58  16.03  11.56  12.19  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
68360  Revise eyelid lining                              A   5.17   9.01     9.49     5.72     6.34     1.02  15.20  15.68  11.91  12.53  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
68362  Revise eyelid lining                              A   8.61   8.81NA   9.86NA   8.81     9.86     1.68  19.10  20.15  19.10  20.15  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
68371  Harvest eye tissue alograft                       A   5.09   5.93NA   6.50NA   5.93     6.50     0.35  11.37  11.94  11.37  11.94  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68399  Eyelid lining surgery                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
68400  Incise/drain tear gland                           A   1.74   5.90     5.97     1.83     1.96     0.34   7.98   8.05   3.91   4.04  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68420  Incise/drain tear sac                             A   2.35   6.30     6.43     2.21     2.39     0.30   8.95   9.08   4.86   5.04  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68440  Incise tear duct opening                          A   0.99   1.83     1.85     1.64     1.77     0.20   3.02   3.04   2.83   2.96  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68500  Removal of tear gland                             A  12.77  13.13NA  14.66NA  13.13    14.66     2.99  28.89  30.42  28.89  30.42  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
68505  Partial removal tear gland                        A  12.69  13.23NA  14.60NA  13.23    14.60     2.47  28.39  29.76  28.39  29.76  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
68510  Biopsy of tear gland                              A   4.60   7.46     7.76     3.19     3.70     0.90  12.96  13.26   8.69   9.20  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
68520  Removal of tear sac                               A   8.78   9.52NA  10.49NA   9.52    10.49     1.14  19.44  20.41  19.44  20.41  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
68525  Biopsy of tear sac                                A   4.42   2.66NA   3.11NA   2.66     3.11     0.86   7.94   8.39   7.94   8.39  0000.00.00.0021110             25.5217 090 99      0.00   0.00   0.00
68530  Clearance of tear duct                            A   3.70   7.90     8.05     3.21     3.56     0.72  12.32  12.47   7.63   7.98  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68540  Remove tear gland lesion                          A  12.18  12.53NA  13.95NA  12.53    13.95     1.56  26.27  27.69  26.27  27.69  0090.10.70.2021110             25.5217 090 99      0.00   0.00   0.00
68550  Remove tear gland lesion                          A  15.16  15.09NA  16.89NA  15.09    16.89     1.93  32.18  33.98  32.18  33.98  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
68700  Repair tear ducts                                 A   7.87   8.17NA   9.12NA   8.17     9.12     1.53  17.57  18.52  17.57  18.52  0090.10.70.2021100             25.5217 090 99      0.00   0.00   0.00
68705  Revise tear duct opening                          A   2.11   4.26     4.40     2.31     2.56     0.41   6.78   6.92   4.83   5.08  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68720  Create tear sac drain                             A   9.96  10.20NA  11.32NA  10.20    11.32     1.66  21.82  22.94  21.82  22.94  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
68745  Create tear duct drain                            A   9.90  10.34NA  11.47NA  10.34    11.47     1.94  22.18  23.31  22.18  23.31  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
68750  Create tear duct drain                            A  10.10  10.85NA  12.02NA  10.85    12.02     1.97  22.92  24.09  22.92  24.09  0090.10.70.2021210             25.5217 090 99      0.00   0.00   0.00
68760  Close tear duct opening                           A   1.78   3.63     3.75     2.10     2.31     0.34   5.75   5.87   4.22   4.43  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68761  Close tear duct opening                           A   1.41   2.55     2.68     1.76     1.92     0.22   4.18   4.31   3.39   3.55  0010.10.80.1021000             25.5217 090 99      0.00   0.00   0.00
68770  Close tear system fistula                         A   8.29   7.96NA   9.41NA   7.96     9.41     1.62  17.87  19.32  17.87  19.32  0090.10.70.2021000             25.5217 090 99      0.00   0.00   0.00
68801  Dilate tear duct opening                          A   1.00   2.35     2.45     1.88     2.00     0.16   3.51   3.61   3.04   3.16  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68810  Probe nasolacrimal duct                           A   2.15   4.30     4.54     2.90     3.09     0.39   6.84   7.08   5.44   5.63  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68811  Probe nasolacrimal duct                           A   2.45   3.06NA   3.34NA   3.06     3.34     0.48   5.99   6.27   5.99   6.27  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68815  Probe nasolacrimal duct                           A   3.30   8.76     9.01     3.57     3.93     0.58  12.64  12.89   7.45   7.81  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68816  Probe nl duct w/balloon                           A   3.06  16.34    17.09     3.60     4.00     0.60  20.00  20.75   7.26   7.66  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68840  Explore/irrigate tear ducts                       A   1.30   2.08     2.26     1.76     1.96     0.24   3.62   3.80   3.30   3.50  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
68850  Injection for tear sac x-ray                      A   0.80   0.90     0.84     0.75     0.70     0.07   1.77   1.71   1.62   1.57  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
68899  Tear duct system surgery                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
69000  Drain external ear lesion                         A   1.50   3.67     3.80     1.78     1.89     0.22   5.39   5.52   3.50   3.61  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
69005  Drain external ear lesion                         A   2.16   3.84     4.00     2.22     2.35     0.29   6.29   6.45   4.67   4.80  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
69020  Drain outer ear canal lesion                      A   1.53   5.12     5.25     2.51     2.61     0.20   6.85   6.98   4.24   4.34  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
69090  Pierce earlobes                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
69100  Biopsy of external ear                            A   0.81   2.12     2.03     0.55     0.60     0.11   3.04   2.95   1.47   1.52  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
69105  Biopsy of external ear canal                      A   0.85   3.20     3.26     0.95     1.00     0.10   4.15   4.21   1.90   1.95  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
69110  Remove external ear partial                       A   3.53   9.45     9.61     5.66     5.80     0.53  13.51  13.67   9.72   9.86  0090.07.79.1420100             25.5217 090 99      0.00   0.00   0.00
69120  Removal of external ear                           A   4.14   7.21NA   7.53NA   7.21     7.53     0.60  11.95  12.27  11.95  12.27  0090.07.79.1420100             25.5217 090 99      0.00   0.00   0.00
69140  Remove ear canal lesion(s)                        A   8.14  16.82NA  17.35NA  16.82    17.35     1.05  26.01  26.54  26.01  26.54  0090.07.79.1420000             25.5217 090 99      0.00   0.00   0.00
69145  Remove ear canal lesion(s)                        A   2.70   8.54     8.89     4.35     4.57     0.35  11.59  11.94   7.40   7.62  0090.07.79.1420100             25.5217 090 99      0.00   0.00   0.00
69150  Extensive ear canal surgery                       A  13.61  15.60NA  16.24NA  15.60    16.24     1.94  31.15  31.79  31.15  31.79  0090.07.79.1420110             25.5217 090 99      0.00   0.00   0.00
69155  Extensive ear/neck surgery                        A  23.35  23.64NA  24.99NA  23.64    24.99     3.00  49.99  51.34  49.99  51.34  0090.07.79.1420210             25.5217 090 99      0.00   0.00   0.00
69200  Clear outer ear canal                             A   0.77   2.75     2.80     0.81     0.88     0.10   3.62   3.67   1.68   1.75  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
69205  Clear outer ear canal                             A   1.21   1.64NA   1.72NA   1.64     1.72     0.16   3.01   3.09   3.01   3.09  0010.10.80.1020100             25.5217 090 99      0.00   0.00   0.00
69210  Remove impacted ear wax                           A   0.61   0.79     0.85     0.28     0.32     0.07   1.47   1.53   0.96   1.00  0000.00.00.0022100             25.5217 090 99      0.00   0.00   0.00
69220  Clean out mastoid cavity                          A   0.83   3.14     3.21     0.92     0.97     0.10   4.07   4.14   1.85   1.90  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
69222  Clean out mastoid cavity                          A   1.45   4.89     4.99     2.47     2.54     0.18   6.52   6.62   4.10   4.17  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
69300  Revise external ear                               R   6.69  12.23    13.43     6.60     7.10     0.86  19.78  20.98  14.15  14.65  0YYY.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
69310  Rebuild outer ear canal                           A  10.97  19.93NA  20.58NA  19.93    20.58     1.44  32.34  32.99  32.34  32.99  0090.07.79.1420100             25.5217 090 99      0.00   0.00   0.00
69320  Rebuild outer ear canal                           A  17.18  26.32NA  27.24NA  26.32    27.24     2.20  45.70  46.62  45.70  46.62  0090.07.79.1420200             25.5217 090 99      0.00   0.00   0.00
69399  Outer ear surgery procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0020011             25.5217 090 99      0.00   0.00   0.00
69400  Inflate middle ear canal                          A   0.83   3.36     3.49     0.91     0.97     0.10   4.29   4.42   1.84   1.90  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
69401  Inflate middle ear canal                          A   0.63   1.80     1.90     0.76     0.80     0.07   2.50   2.60   1.46   1.50  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
69405  Catheterize middle ear canal                      A   2.68   4.69     4.93     2.74     2.90     0.34   7.71   7.95   5.76   5.92  0010.10.80.1020000             25.5217 090 99      0.00   0.00   0.00
69420  Incision of eardrum                               A   1.38   4.11     4.22     2.03     2.13     0.18   5.67   5.78   3.59   3.69  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
69421  Incision of eardrum                               A   1.78   2.48NA   2.57NA   2.48     2.57     0.23   4.49   4.58   4.49   4.58  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
69424  Remove ventilating tube                           A   0.85   2.85     2.90     0.90     0.95     0.10   3.80   3.85   1.85   1.90  0000.00.00.0021100             25.5217 090 99      0.00   0.00   0.00
69433  Create eardrum opening                            A   1.57   4.12     4.26     2.10     2.21     0.22   5.91   6.05   3.89   4.00  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
69436  Create eardrum opening                            A   2.01   2.57NA   2.66NA   2.57     2.66     0.26   4.84   4.93   4.84   4.93  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
69440  Exploration of middle ear                         A   7.71  11.76NA  12.39NA  11.76    12.39     0.99  20.46  21.09  20.46  21.09  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69450  Eardrum revision                                  A   5.69   9.72NA  10.21NA   9.72    10.21     0.72  16.13  16.62  16.13  16.62  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69501  Mastoidectomy                                     A   9.21  11.41NA  12.08NA  11.41    12.08     1.18  21.80  22.47  21.80  22.47  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69502  Mastoidectomy                                     A  12.56  14.73NA  15.60NA  14.73    15.60     1.68  28.97  29.84  28.97  29.84  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69505  Remove mastoid structures                         A  13.17  21.00NA  21.83NA  21.00    21.83     1.70  35.87  36.70  35.87  36.70  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69511  Extensive mastoid surgery                         A  13.70  21.34NA  22.15NA  21.34    22.15     1.77  36.81  37.62  36.81  37.62  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69530  Extensive mastoid surgery                         A  20.38  26.40NA  27.62NA  26.40    27.62     2.61  49.39  50.61  49.39  50.61  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69535  Remove part of temporal bone                      A  37.42  37.37NA  39.58NA  37.37    39.58     5.21  80.00  82.21  80.00  82.21  0090.07.79.1421110             25.5217 090 99      0.00   0.00   0.00
69540  Remove ear lesion                                 A   1.25   4.78     4.88     2.39     2.47     0.16   6.19   6.29   3.80   3.88  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
69550  Remove ear lesion                                 A  11.15  18.44NA  19.14NA  18.44    19.14     1.44  31.03  31.73  31.03  31.73  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69552  Remove ear lesion                                 A  19.81  24.56NA  25.75NA  24.56    25.75     2.54  46.91  48.10  46.91  48.10  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69554  Remove ear lesion                                 A  35.97  34.18NA  37.14NA  34.18    37.14     4.60  74.75  77.71  74.75  77.71  0090.07.79.1421210             25.5217 090 99      0.00   0.00   0.00
69601  Mastoid surgery revision                          A  13.45  16.04NA  16.99NA  16.04    16.99     1.71  31.20  32.15  31.20  32.15  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69602  Mastoid surgery revision                          A  13.76  16.94NA  17.91NA  16.94    17.91     1.77  32.47  33.44  32.47  33.44  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69603  Mastoid surgery revision                          A  14.20  21.70NA  22.44NA  21.70    22.44     1.82  37.72  38.46  37.72  38.46  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69604  Mastoid surgery revision                          A  14.20  17.31NA  18.17NA  17.31    18.17     1.82  33.33  34.19  33.33  34.19  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69605  Mastoid surgery revision                          A  18.69  25.52NA  26.62NA  25.52    26.62     2.39  46.60  47.70  46.60  47.70  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69610  Repair of eardrum                                 A   4.47   6.49     6.71     3.72     3.96     0.58  11.54  11.76   8.77   9.01  0010.10.80.1021100             25.5217 090 99      0.00   0.00   0.00
69620  Repair of eardrum                                 A   6.03  13.78    14.14     7.76     8.13     0.76  20.57  20.93  14.55  14.92  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69631  Repair eardrum structures                         A  10.05  14.94NA  15.72NA  14.94    15.72     1.29  26.28  27.06  26.28  27.06  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69632  Rebuild eardrum structures                        A  12.96  17.50NA  18.44NA  17.50    18.44     1.66  32.12  33.06  32.12  33.06  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69633  Rebuild eardrum structures                        A  12.31  17.10NA  18.00NA  17.10    18.00     1.59  31.00  31.90  31.00  31.90  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69635  Repair eardrum structures                         A  13.51  21.15NA  22.05NA  21.15    22.05     1.74  36.40  37.30  36.40  37.30  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69636  Rebuild eardrum structures                        A  15.43  23.75NA  24.70NA  23.75    24.70     1.97  41.15  42.10  41.15  42.10  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69637  Rebuild eardrum structures                        A  15.32  23.71NA  24.67NA  23.71    24.67     2.00  41.03  41.99  41.03  41.99  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69641  Revise middle ear & mastoid                       A  12.89  16.47NA  17.36NA  16.47    17.36     1.67  31.03  31.92  31.03  31.92  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69642  Revise middle ear & mastoid                       A  17.06  20.68NA  21.83NA  20.68    21.83     2.19  39.93  41.08  39.93  41.08  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69643  Revise middle ear & mastoid                       A  15.59  18.90NA  19.97NA  18.90    19.97     2.00  36.49  37.56  36.49  37.56  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69644  Revise middle ear & mastoid                       A  17.23  24.70NA  25.68NA  24.70    25.68     2.21  44.14  45.12  44.14  45.12  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69645  Revise middle ear & mastoid                       A  16.71  24.46NA  25.46NA  24.46    25.46     2.17  43.34  44.34  43.34  44.34  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69646  Revise middle ear & mastoid                       A  18.37  25.26NA  26.38NA  25.26    26.38     2.35  45.98  47.10  45.98  47.10  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69650  Release middle ear bone                           A   9.80  12.75NA  13.61NA  12.75    13.61     1.25  23.80  24.66  23.80  24.66  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69660  Revise middle ear bone                            A  12.03  14.11NA  14.92NA  14.11    14.92     1.55  27.69  28.50  27.69  28.50  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69661  Revise middle ear bone                            A  15.92  18.17NA  19.19NA  18.17    19.19     2.00  36.09  37.11  36.09  37.11  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69662  Revise middle ear bone                            A  15.60  16.97NA  17.96NA  16.97    17.96     2.00  34.57  35.56  34.57  35.56  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69666  Repair middle ear structures                      A   9.89  12.89NA  13.65NA  12.89    13.65     1.28  24.06  24.82  24.06  24.82  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69667  Repair middle ear structures                      A   9.90  12.92NA  13.63NA  12.92    13.63     1.28  24.10  24.81  24.10  24.81  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69670  Remove mastoid air cells                          A  11.73  14.87NA  15.74NA  14.87    15.74     1.51  28.11  28.98  28.11  28.98  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69676  Remove middle ear nerve                           A   9.69  13.86NA  14.54NA  13.86    14.54     1.24  24.79  25.47  24.79  25.47  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69700  Close mastoid fistula                             A   8.37  11.11NA  11.59NA  11.11    11.59     1.07  20.55  21.03  20.55  21.03  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69710  Implant/replace hearing aid                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
69711  Remove/repair hearing aid                         A  10.62  13.81NA  14.49NA  13.81    14.49     1.36  25.79  26.47  25.79  26.47  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69714  Implant temple bone w/stimul                      A  14.45  15.84NA  16.78NA  15.84    16.78     1.86  32.15  33.09  32.15  33.09  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69715  Temple bne implnt w/stimulat                      A  18.96  18.44NA  19.63NA  18.44    19.63     2.42  39.82  41.01  39.82  41.01  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69717  Temple bone implant revision                      A  15.43  16.58NA  17.40NA  16.58    17.40     1.97  33.98  34.80  33.98  34.80  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69718  Revise temple bone implant                        A  19.21  18.59NA  19.78NA  18.59    19.78     2.44  40.24  41.43  40.24  41.43  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69720  Release facial nerve                              A  14.71  18.44NA  19.47NA  18.44    19.47     1.89  35.04  36.07  35.04  36.07  0090.07.79.1421010             25.5217 090 99      0.00   0.00   0.00
69725  Release facial nerve                              A  27.64  25.14NA  26.95NA  25.14    26.95     3.54  56.32  58.13  56.32  58.13  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69740  Repair facial nerve                               A  16.27  16.61NA  17.65NA  16.61    17.65     2.08  34.96  36.00  34.96  36.00  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69745  Repair facial nerve                               A  17.02  18.06NA  19.08NA  18.06    19.08     2.17  37.25  38.27  37.25  38.27  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69799  Middle ear surgery procedure                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
69801  Incise inner ear                                  A   2.06   3.63     3.63     6.61     1.58     0.27   5.96   5.96   8.94   3.91  0000.00.00.0021000             25.5217 090 99      0.00   0.00   0.00
69802  Incise inner ear                                  A  13.50  15.85NA  16.79NA  15.85    16.79     1.71  31.06  32.00  31.06  32.00  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69805  Explore inner ear                                 A  14.71  14.91NA  15.93NA  14.91    15.93     1.89  31.51  32.53  31.51  32.53  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69806  Explore inner ear                                 A  12.63  13.98NA  14.81NA  13.98    14.81     1.63  28.24  29.07  28.24  29.07  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69820  Establish inner ear window                        A  10.52  13.78NA  14.43NA  13.78    14.43     1.36  25.66  26.31  25.66  26.31  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69840  Revise inner ear window                           A  10.44  13.68NA  12.74NA  13.68    12.74     0.73  24.85  23.91  24.85  23.91  0090.07.79.1421200             25.5217 090 99      0.00   0.00   0.00
69905  Remove inner ear                                  A  11.26  14.71NA  15.46NA  14.71    15.46     1.45  27.42  28.17  27.42  28.17  0090.07.79.1421100             25.5217 090 99      0.00   0.00   0.00
69910  Remove inner ear & mastoid                        A  13.91  14.78NA  15.65NA  14.78    15.65     1.79  30.48  31.35  30.48  31.35  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69915  Incise inner ear nerve                            A  22.77  20.36NA  21.88NA  20.36    21.88     2.96  46.09  47.61  46.09  47.61  0090.07.79.1421210             25.5217 090 99      0.00   0.00   0.00
69930  Implant cochlear device                           A  17.73  16.81NA  17.74NA  16.81    17.74     2.27  36.81  37.74  36.81  37.74  0090.07.79.1421000             25.5217 090 99      0.00   0.00   0.00
69949  Inner ear surgery procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
69950  Incise inner ear nerve                            A  27.63  25.12NA  28.86NA  25.12    28.86     3.54  56.29  60.03  56.29  60.03  0090.07.79.1421210             25.5217 090 99      0.00   0.00   0.00
69955  Release facial nerve                              A  29.42  26.17NA  28.02NA  26.17    28.02     3.78  59.37  61.22  59.37  61.22  0090.07.79.1421210             25.5217 090 99      0.00   0.00   0.00
69960  Release inner ear canal                           A  29.42  24.54NA  26.42NA  24.54    26.42     3.78  57.74  59.62  57.74  59.62  0090.07.79.1421210             25.5217 090 99      0.00   0.00   0.00
69970  Remove inner ear lesion                           A  32.41  27.80NA  29.77NA  27.80    29.77     4.16  64.37  66.34  64.37  66.34  0090.07.79.1421210             25.5217 090 99      0.00   0.00   0.00
69979  Temporal bone surgery                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0021011             25.5217 090 99      0.00   0.00   0.00
69990  Microsurgery add-on                               R   3.46   1.87NA   1.94NA   1.87     1.94     1.15   6.48   6.55   6.48   6.55  0ZZZ.00.00.0000200             25.5217 090 99      0.00   0.00   0.00
70010  Contrast x-ray of brain                           A   1.19   2.39     0.80     2.39     0.80     0.16   3.74   2.15   3.74   2.15  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70015  Contrast x-ray of brain                           A   1.19   3.10     3.02     3.10NA   3.02 NA  0.08   4.37   4.29   4.37   4.29  1XXX.00.00.0000000             25.5217 090 99     19.98  19.98   0.14
70015TCContrast x-ray of brain                           A   0.00   2.60     2.57     2.60NA   2.57 NA  0.01   2.61   2.58   2.61   2.58  1XXX.00.00.0000000             25.5217 030 99     19.48  19.48   0.07
7001526Contrast x-ray of brain                           A   1.19   0.50     0.45     0.50     0.45     0.07   1.76   1.71   1.76   1.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70030  X-ray eye for foreign body                        A   0.17   0.67     0.63     0.67NA   0.63 NA  0.02   0.86   0.82   0.86   0.82  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.04
70030TCX-ray eye for foreign body                        A   0.00   0.60     0.57     0.60NA   0.57 NA  0.01   0.61   0.58   0.61   0.58  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7003026X-ray eye for foreign body                        A   0.17   0.07     0.06     0.07     0.06     0.01   0.25   0.24   0.25   0.24  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
7010F  Pt info into recall system                        M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
70100  X-ray exam of jaw                                 A   0.18   0.78     0.80     0.78NA   0.80 NA  0.02   0.98   1.00   0.98   1.00  1XXX.00.00.0000000             25.5217 090 99      1.82   1.82   0.03
70100TCX-ray exam of jaw                                 A   0.00   0.70     0.72     0.70NA   0.72 NA  0.01   0.71   0.73   0.71   0.73  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7010026X-ray exam of jaw                                 A   0.18   0.08     0.08     0.08     0.08     0.01   0.27   0.27   0.27   0.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70110  X-ray exam of jaw                                 A   0.25   0.90     0.86     0.90NA   0.86 NA  0.02   1.17   1.13   1.17   1.13  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.03
70110TCX-ray exam of jaw                                 A   0.00   0.80     0.76     0.80NA   0.76 NA  0.01   0.81   0.77   0.81   0.77  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7011026X-ray exam of jaw                                 A   0.25   0.10     0.10     0.10     0.10     0.01   0.36   0.36   0.36   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70120  X-ray exam of mastoids                            A   0.18   0.85     0.85     0.85NA   0.85 NA  0.02   1.05   1.05   1.05   1.05  1XXX.00.00.0003000             25.5217 090 99      1.82   1.82   0.03
70120TCX-ray exam of mastoids                            A   0.00   0.77     0.77     0.77NA   0.77 NA  0.01   0.78   0.78   0.78   0.78  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.02
7012026X-ray exam of mastoids                            A   0.18   0.08     0.08     0.08     0.08     0.01   0.27   0.27   0.27   0.27  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
70130  X-ray exam of mastoids                            A   0.34   1.31     1.28     1.31NA   1.28 NA  0.02   1.67   1.64   1.67   1.64  1XXX.00.00.0003000             25.5217 090 99      1.89   1.89   0.02
70130TCX-ray exam of mastoids                            A   0.00   1.17     1.14     1.17NA   1.14 NA  0.01   1.18   1.15   1.18   1.15  1XXX.00.00.0003000             25.5217 010 99      1.75   1.75   0.01
7013026X-ray exam of mastoids                            A   0.34   0.14     0.14     0.14     0.14     0.01   0.49   0.49   0.49   0.49  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
70134  X-ray exam of middle ear                          A   0.34   1.02     0.95     1.02NA   0.95 NA  0.02   1.38   1.31   1.38   1.31  1XXX.00.00.0000000             25.5217 090 99      3.08   3.08   0.04
70134TCX-ray exam of middle ear                          A   0.00   0.88     0.82     0.88NA   0.82 NA  0.01   0.89   0.83   0.89   0.83  1XXX.00.00.0000000             25.5217 010 99      2.94   2.94   0.03
7013426X-ray exam of middle ear                          A   0.34   0.14     0.13     0.14     0.13     0.01   0.49   0.48   0.49   0.48  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70140  X-ray exam of facial bones                        A   0.19   0.69     0.66     0.69NA   0.66 NA  0.02   0.90   0.87   0.90   0.87  1XXX.00.00.0000000             25.5217 090 99      1.83   1.83   0.04
70140TCX-ray exam of facial bones                        A   0.00   0.60     0.56     0.60NA   0.56 NA  0.01   0.61   0.57   0.61   0.57  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7014026X-ray exam of facial bones                        A   0.19   0.09     0.10     0.09     0.10     0.01   0.29   0.30   0.29   0.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70150  X-ray exam of facial bones                        A   0.26   0.99     0.94     0.99NA   0.94 NA  0.02   1.27   1.22   1.27   1.22  1XXX.00.00.0000000             25.5217 090 99      1.85   1.85   0.03
70150TCX-ray exam of facial bones                        A   0.00   0.88     0.83     0.88NA   0.83 NA  0.01   0.89   0.84   0.89   0.84  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7015026X-ray exam of facial bones                        A   0.26   0.11     0.11     0.11     0.11     0.01   0.38   0.38   0.38   0.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70160  X-ray exam of nasal bones                         A   0.17   0.79     0.77     0.79NA   0.77 NA  0.02   0.98   0.96   0.98   0.96  1XXX.00.00.0000000             25.5217 090 99      1.81   1.81   0.03
70160TCX-ray exam of nasal bones                         A   0.00   0.72     0.70     0.72NA   0.70 NA  0.01   0.73   0.71   0.73   0.71  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7016026X-ray exam of nasal bones                         A   0.17   0.07     0.07     0.07     0.07     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70170  X-ray exam of tear duct                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      9.12   9.12   0.04
70170TCX-ray exam of tear duct                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      9.00   9.00   0.01
7017026X-ray exam of tear duct                           A   0.30   0.12     0.11     0.12     0.11     0.03   0.45   0.44   0.45   0.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70190  X-ray exam of eye sockets                         A   0.21   0.84     0.80     0.84NA   0.80 NA  0.02   1.07   1.03   1.07   1.03  1XXX.00.00.0003000             25.5217 090 99      1.83   1.83   0.03
70190TCX-ray exam of eye sockets                         A   0.00   0.75     0.71     0.75NA   0.71 NA  0.01   0.76   0.72   0.76   0.72  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.02
7019026X-ray exam of eye sockets                         A   0.21   0.09     0.09     0.09     0.09     0.01   0.31   0.31   0.31   0.31  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
7020F  Mammo assess cat in dbase                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
70200  X-ray exam of eye sockets                         A   0.28   1.01     0.94     1.01NA   0.94 NA  0.02   1.31   1.24   1.31   1.24  1XXX.00.00.0000000             25.5217 090 99      1.87   1.87   0.03
70200TCX-ray exam of eye sockets                         A   0.00   0.89     0.83     0.89NA   0.83 NA  0.01   0.90   0.84   0.90   0.84  1XXX.00.00.0000000             25.5217 010 99      1.75   1.75   0.02
7020026X-ray exam of eye sockets                         A   0.28   0.12     0.11     0.12     0.11     0.01   0.41   0.40   0.41   0.40  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70210  X-ray exam of sinuses                             A   0.17   0.73     0.71     0.73NA   0.71 NA  0.02   0.92   0.90   0.92   0.90  1XXX.00.00.0000000             25.5217 090 99      1.82   1.82   0.04
70210TCX-ray exam of sinuses                             A   0.00   0.65     0.63     0.65NA   0.63 NA  0.01   0.66   0.64   0.66   0.64  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7021026X-ray exam of sinuses                             A   0.17   0.08     0.08     0.08     0.08     0.01   0.26   0.26   0.26   0.26  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70220  X-ray exam of sinuses                             A   0.25   0.89     0.85     0.89NA   0.85 NA  0.02   1.16   1.12   1.16   1.12  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.03
70220TCX-ray exam of sinuses                             A   0.00   0.79     0.74     0.79NA   0.74 NA  0.01   0.80   0.75   0.80   0.75  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7022026X-ray exam of sinuses                             A   0.25   0.10     0.11     0.10     0.11     0.01   0.36   0.37   0.36   0.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70240  X-ray exam pituitary saddle                       A   0.19   0.68     0.64     0.68NA   0.64 NA  0.02   0.89   0.85   0.89   0.85  1XXX.00.00.0000000             25.5217 090 99      1.82   1.82   0.04
70240TCX-ray exam pituitary saddle                       A   0.00   0.60     0.56     0.60NA   0.56 NA  0.01   0.61   0.57   0.61   0.57  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7024026X-ray exam pituitary saddle                       A   0.19   0.08     0.08     0.08     0.08     0.01   0.28   0.28   0.28   0.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7025F  Pt infosys alarm 4 nxt mammo                      M   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
70250  X-ray exam of skull                               A   0.24   0.84     0.81     0.84NA   0.81 NA  0.02   1.10   1.07   1.10   1.07  1XXX.00.00.0000000             25.5217 090 99      1.85   1.85   0.03
70250TCX-ray exam of skull                               A   0.00   0.73     0.70     0.73NA   0.70 NA  0.01   0.74   0.71   0.74   0.71  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7025026X-ray exam of skull                               A   0.24   0.11     0.11     0.11     0.11     0.01   0.36   0.36   0.36   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70260  X-ray exam of skull                               A   0.34   1.05     0.99     1.05NA   0.99 NA  0.02   1.41   1.35   1.41   1.35  1XXX.00.00.0000000             25.5217 090 99      3.08   3.08   0.04
70260TCX-ray exam of skull                               A   0.00   0.91     0.84     0.91NA   0.84 NA  0.01   0.92   0.85   0.92   0.85  1XXX.00.00.0000000             25.5217 010 99      2.94   2.94   0.03
7026026X-ray exam of skull                               A   0.34   0.14     0.15     0.14     0.15     0.01   0.49   0.50   0.49   0.50  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70300  X-ray exam of teeth                               A   0.10   0.32     0.31     0.32NA   0.31 NA  0.02   0.44   0.43   0.44   0.43  1XXX.00.00.0000000             25.5217 090 99      1.21   1.21   0.05
70300TCX-ray exam of teeth                               A   0.00   0.26     0.24     0.26NA   0.24 NA  0.01   0.27   0.25   0.27   0.25  1XXX.00.00.0000000             25.5217 010 99      1.15   1.15   0.04
7030026X-ray exam of teeth                               A   0.10   0.06     0.07     0.06     0.07     0.01   0.17   0.18   0.17   0.18  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70310  X-ray exam of teeth                               A   0.16   0.93     0.97     0.93NA   0.97 NA  0.02   1.11   1.15   1.11   1.15  1XXX.00.00.0000000             25.5217 090 99      1.27   1.27   0.02
70310TCX-ray exam of teeth                               A   0.00   0.84     0.86     0.84NA   0.86 NA  0.01   0.85   0.87   0.85   0.87  1XXX.00.00.0000000             25.5217 010 99      1.18   1.18   0.01
7031026X-ray exam of teeth                               A   0.16   0.09     0.11     0.09     0.11     0.01   0.26   0.28   0.26   0.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70320  Full mouth x-ray of teeth                         A   0.22   1.25     1.26     1.25NA   1.26 NA  0.02   1.49   1.50   1.49   1.50  1XXX.00.00.0000000             25.5217 090 99      1.29   1.29   0.02
70320TCFull mouth x-ray of teeth                         A   0.00   1.14     1.13     1.14NA   1.13 NA  0.01   1.15   1.14   1.15   1.14  1XXX.00.00.0000000             25.5217 010 99      1.18   1.18   0.01
7032026Full mouth x-ray of teeth                         A   0.22   0.11     0.13     0.11     0.13     0.01   0.34   0.36   0.34   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70328  X-ray exam of jaw joint                           A   0.18   0.72     0.70     0.72NA   0.70 NA  0.02   0.92   0.90   0.92   0.90  1XXX.00.00.0000000             25.5217 090 99      1.82   1.82   0.04
70328TCX-ray exam of jaw joint                           A   0.00   0.64     0.62     0.64NA   0.62 NA  0.01   0.65   0.63   0.65   0.63  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7032826X-ray exam of jaw joint                           A   0.18   0.08     0.08     0.08     0.08     0.01   0.27   0.27   0.27   0.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70330  X-ray exam of jaw joints                          A   0.24   1.17     1.14     1.17NA   1.14 NA  0.02   1.43   1.40   1.43   1.40  1XXX.00.00.0002000             25.5217 090 99      1.86   1.86   0.03
70330TCX-ray exam of jaw joints                          A   0.00   1.06     1.02     1.06NA   1.02 NA  0.01   1.07   1.03   1.07   1.03  1XXX.00.00.0002000             25.5217 010 99      1.75   1.75   0.02
7033026X-ray exam of jaw joints                          A   0.24   0.11     0.12     0.11     0.12     0.01   0.36   0.37   0.36   0.37  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
70332  X-ray exam of jaw joint                           A   0.54   1.95     1.88     1.95NA   1.88 NA  0.04   2.53   2.46   2.53   2.46  1XXX.00.00.0003000             25.5217 090 99     10.98  10.98   0.09
70332TCX-ray exam of jaw joint                           A   0.00   1.68     1.57     1.68NA   1.57 NA  0.01   1.69   1.58   1.69   1.58  1XXX.00.00.0003000             25.5217 030 99     10.71  10.71   0.06
7033226X-ray exam of jaw joint                           A   0.54   0.27     0.31     0.27     0.31     0.03   0.84   0.88   0.84   0.88  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
70336  Magnetic image jaw joint                          A   1.48  11.80     8.94    11.80NA   8.94 NA  0.09  13.37  10.51  13.37  10.51  1XXX.00.00.0040000             25.5217 090 88     14.02  14.02   0.09
70336TCMagnetic image jaw joint                          A   0.00  11.20     8.40    11.20NA   8.40 NA  0.01  11.21   8.41  11.21   8.41  1XXX.00.00.0040000             25.5217 010 88     13.42  13.42   0.01
7033626Magnetic image jaw joint                          A   1.48   0.60     0.54     0.60     0.54     0.08   2.16   2.10   2.16   2.10  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
70350  X-ray head for orthodontia                        A   0.17   0.44     0.44     0.44NA   0.44 NA  0.02   0.63   0.63   0.63   0.63  1XXX.00.00.0000000             25.5217 090 99      1.81   1.81   0.06
70350TCX-ray head for orthodontia                        A   0.00   0.34     0.32     0.34NA   0.32 NA  0.01   0.35   0.33   0.35   0.33  1XXX.00.00.0000000             25.5217 010 99      1.71   1.71   0.05
7035026X-ray head for orthodontia                        A   0.17   0.10     0.12     0.10     0.12     0.01   0.28   0.30   0.28   0.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70355  Panoramic x-ray of jaws                           A   0.20   0.42     0.39     0.42NA   0.39 NA  0.02   0.64   0.61   0.64   0.61  1XXX.00.00.0000000             25.5217 090 99      1.26   1.26   0.05
70355TCPanoramic x-ray of jaws                           A   0.00   0.32     0.27     0.32NA   0.27 NA  0.01   0.33   0.28   0.33   0.28  1XXX.00.00.0000000             25.5217 010 99      1.16   1.16   0.04
7035526Panoramic x-ray of jaws                           A   0.20   0.10     0.12     0.10     0.12     0.01   0.31   0.33   0.31   0.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70360  X-ray exam of neck                                A   0.17   0.63     0.60     0.63NA   0.60 NA  0.02   0.82   0.79   0.82   0.79  1XXX.00.00.0000000             25.5217 090 99      1.80   1.80   0.04
70360TCX-ray exam of neck                                A   0.00   0.56     0.53     0.56NA   0.53 NA  0.01   0.57   0.54   0.57   0.54  1XXX.00.00.0000000             25.5217 010 99      1.73   1.73   0.03
7036026X-ray exam of neck                                A   0.17   0.07     0.07     0.07     0.07     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70370  Throat x-ray & fluoroscopy                        A   0.32   2.08     2.14     2.08NA   2.14 NA  0.02   2.42   2.48   2.42   2.48  1XXX.00.00.0000000             25.5217 090 99      3.39   3.39   0.03
70370TCThroat x-ray & fluoroscopy                        A   0.00   1.94     2.00     1.94NA   2.00 NA  0.01   1.95   2.01   1.95   2.01  1XXX.00.00.0000000             25.5217 030 99      3.25   3.25   0.02
7037026Throat x-ray & fluoroscopy                        A   0.32   0.14     0.14     0.14     0.14     0.01   0.47   0.47   0.47   0.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70371  Speech evaluation complex                         A   0.84   1.92     1.77     1.92NA   1.77 NA  0.04   2.80   2.65   2.80   2.65  1XXX.00.00.0000000             25.5217 090 99      3.59   3.59   0.05
70371TCSpeech evaluation complex                         A   0.00   1.58     1.41     1.58NA   1.41 NA  0.01   1.59   1.42   1.59   1.42  1XXX.00.00.0000000             25.5217 030 99      3.25   3.25   0.02
7037126Speech evaluation complex                         A   0.84   0.34     0.36     0.34     0.36     0.03   1.21   1.23   1.21   1.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70373  Contrast x-ray of larynx                          A   0.44   1.97     1.92     1.97NA   1.92 NA  0.02   2.43   2.38   2.43   2.38  1XXX.00.00.0000000             25.5217 090 99      9.13   9.13   0.06
70373TCContrast x-ray of larynx                          A   0.00   1.80     1.74     1.80NA   1.74 NA  0.01   1.81   1.75   1.81   1.75  1XXX.00.00.0000000             25.5217 030 99      8.96   8.96   0.05
7037326Contrast x-ray of larynx                          A   0.44   0.17     0.18     0.17     0.18     0.01   0.62   0.63   0.62   0.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70380  X-ray exam of salivary gland                      A   0.17   0.98     1.00     0.98NA   1.00 NA  0.02   1.17   1.19   1.17   1.19  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.03
70380TCX-ray exam of salivary gland                      A   0.00   0.89     0.89     0.89NA   0.89 NA  0.01   0.90   0.90   0.90   0.90  1XXX.00.00.0000000             25.5217 010 99      1.75   1.75   0.02
7038026X-ray exam of salivary gland                      A   0.17   0.09     0.11     0.09     0.11     0.01   0.27   0.29   0.27   0.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70390  X-ray exam of salivary duct                       A   0.38   2.60     2.48     2.60NA   2.48 NA  0.04   3.02   2.90   3.02   2.90  1XXX.00.00.0000000             25.5217 090 99      9.13   9.13   0.07
70390TCX-ray exam of salivary duct                       A   0.00   2.44     2.33     2.44NA   2.33 NA  0.01   2.45   2.34   2.45   2.34  1XXX.00.00.0000000             25.5217 030 99      8.97   8.97   0.04
7039026X-ray exam of salivary duct                       A   0.38   0.16     0.15     0.16     0.15     0.03   0.57   0.56   0.57   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70450  Ct head/brain w/o dye                             A   0.85   4.92     3.85     4.92NA   3.85 NA  0.05   5.82   4.75   5.82   4.75  1XXX.00.00.0040000             25.5217 090 88      7.93   7.93   0.06
70450TCCt head/brain w/o dye                             A   0.00   4.57     3.53     4.57NA   3.53 NA  0.01   4.58   3.54   4.58   3.54  1XXX.00.00.0040000             25.5217 010 88      7.58   7.58   0.02
7045026Ct head/brain w/o dye                             A   0.85   0.35     0.32     0.35     0.32     0.04   1.24   1.21   1.24   1.21  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70460  Ct head/brain w/dye                               A   1.13   6.41     5.06     6.41NA   5.06 NA  0.06   7.60   6.25   7.60   6.25  1XXX.00.00.0040000             25.5217 090 88     12.20  12.20   0.07
70460TCCt head/brain w/dye                               A   0.00   5.94     4.63     5.94NA   4.63 NA  0.01   5.95   4.64   5.95   4.64  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.02
7046026Ct head/brain w/dye                               A   1.13   0.47     0.43     0.47     0.43     0.05   1.65   1.61   1.65   1.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70470  Ct head/brain w/o & w/dye                         A   1.27   7.84     6.18     7.84NA   6.18 NA  0.08   9.19   7.53   9.19   7.53  1XXX.00.00.0040000             25.5217 090 88     13.61  13.61   0.09
70470TCCt head/brain w/o & w/dye                         A   0.00   7.31     5.70     7.31NA   5.70 NA  0.01   7.32   5.71   7.32   5.71  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.02
7047026Ct head/brain w/o & w/dye                         A   1.27   0.53     0.48     0.53     0.48     0.07   1.87   1.82   1.87   1.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70480  Ct orbit/ear/fossa w/o dye                        A   1.28   7.98     6.66     7.98NA   6.66 NA  0.08   9.34   8.02   9.34   8.02  1XXX.00.00.0040000             25.5217 090 88      8.13   8.13   0.08
70480TCCt orbit/ear/fossa w/o dye                        A   0.00   7.44     6.17     7.44NA   6.17 NA  0.01   7.45   6.18   7.45   6.18  1XXX.00.00.0040000             25.5217 010 88      7.59   7.59   0.01
7048026Ct orbit/ear/fossa w/o dye                        A   1.28   0.54     0.49     0.54     0.49     0.07   1.89   1.84   1.89   1.84  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70481  Ct orbit/ear/fossa w/dye                          A   1.38   9.36     7.78     9.36NA   7.78 NA  0.09  10.83   9.25  10.83   9.25  1XXX.00.00.0040000             25.5217 090 88     12.30  12.30   0.09
70481TCCt orbit/ear/fossa w/dye                          A   0.00   8.79     7.26     8.79NA   7.26 NA  0.01   8.80   7.27   8.80   7.27  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.01
7048126Ct orbit/ear/fossa w/dye                          A   1.38   0.57     0.52     0.57     0.52     0.08   2.03   1.98   2.03   1.98  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70482  Ct orbit/ear/fossa w/o&w/dye                      A   1.45  10.70     8.72    10.70NA   8.72 NA  0.09  12.24  10.26  12.24  10.26  1XXX.00.00.0040000             25.5217 090 88     13.68  13.68   0.09
70482TCCt orbit/ear/fossa w/o&w/dye                      A   0.00  10.10     8.18    10.10NA   8.18 NA  0.01  10.11   8.19  10.11   8.19  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.01
7048226Ct orbit/ear/fossa w/o&w/dye                      A   1.45   0.60     0.54     0.60     0.54     0.08   2.13   2.07   2.13   2.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70486  Ct maxillofacial w/o dye                          A   1.14   6.57     5.40     6.57NA   5.40 NA  0.06   7.77   6.60   7.77   6.60  1XXX.00.00.0040000             25.5217 090 88      8.06   8.06   0.06
70486TCCt maxillofacial w/o dye                          A   0.00   6.09     4.95     6.09NA   4.95 NA  0.01   6.10   4.96   6.10   4.96  1XXX.00.00.0040000             25.5217 010 88      7.58   7.58   0.01
7048626Ct maxillofacial w/o dye                          A   1.14   0.48     0.45     0.48     0.45     0.05   1.67   1.64   1.67   1.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70487  Ct maxillofacial w/dye                            A   1.30   7.99     6.52     7.99NA   6.52 NA  0.08   9.37   7.90   9.37   7.90  1XXX.00.00.0040000             25.5217 090 88     12.27  12.27   0.09
70487TCCt maxillofacial w/dye                            A   0.00   7.45     6.03     7.45NA   6.03 NA  0.01   7.46   6.04   7.46   6.04  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.02
7048726Ct maxillofacial w/dye                            A   1.30   0.54     0.49     0.54     0.49     0.07   1.91   1.86   1.91   1.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70488  Ct maxillofacial w/o & w/dye                      A   1.42   9.89     8.04     9.89NA   8.04 NA  0.09  11.40   9.55  11.40   9.55  1XXX.00.00.0040000             25.5217 090 88     13.67  13.67   0.09
70488TCCt maxillofacial w/o & w/dye                      A   0.00   9.30     7.50     9.30NA   7.50 NA  0.01   9.31   7.51   9.31   7.51  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.01
7048826Ct maxillofacial w/o & w/dye                      A   1.42   0.59     0.54     0.59     0.54     0.08   2.09   2.04   2.09   2.04  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70490  Ct soft tissue neck w/o dye                       A   1.28   6.27     5.05     6.27NA   5.05 NA  0.08   7.63   6.41   7.63   6.41  1XXX.00.00.0040000             25.5217 090 88      8.12   8.12   0.08
70490TCCt soft tissue neck w/o dye                       A   0.00   5.73     4.57     5.73NA   4.57 NA  0.01   5.74   4.58   5.74   4.58  1XXX.00.00.0040000             25.5217 010 88      7.58   7.58   0.01
7049026Ct soft tissue neck w/o dye                       A   1.28   0.54     0.48     0.54     0.48     0.07   1.89   1.83   1.89   1.83  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70491  Ct soft tissue neck w/dye                         A   1.38   7.73     6.27     7.73NA   6.27 NA  0.08   9.19   7.73   9.19   7.73  1XXX.00.00.0040000             25.5217 090 88     12.31  12.31   0.09
70491TCCt soft tissue neck w/dye                         A   0.00   7.15     5.74     7.15NA   5.74 NA  0.01   7.16   5.75   7.16   5.75  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.02
7049126Ct soft tissue neck w/dye                         A   1.38   0.58     0.53     0.58     0.53     0.07   2.03   1.98   2.03   1.98  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70492  Ct sft tsue nck w/o & w/dye                       A   1.45   9.56     7.69     9.56NA   7.69 NA  0.09  11.10   9.23  11.10   9.23  1XXX.00.00.0040000             25.5217 090 88     13.68  13.68   0.09
70492TCCt sft tsue nck w/o & w/dye                       A   0.00   8.96     7.15     8.96NA   7.15 NA  0.01   8.97   7.16   8.97   7.16  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.01
7049226Ct sft tsue nck w/o & w/dye                       A   1.45   0.60     0.54     0.60     0.54     0.08   2.13   2.07   2.13   2.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70496  Ct angiography head                               A   1.75  15.76    12.58    15.76NA  12.58 NA  0.11  17.62  14.44  17.62  14.44  1XXX.00.00.0040000             25.5217 090 88     13.99  13.99   0.11
70496TCCt angiography head                               A   0.00  15.03    11.93    15.03NA  11.93 NA  0.01  15.04  11.94  15.04  11.94  1XXX.00.00.0040000             25.5217 020 88     13.26  13.26   0.01
7049626Ct angiography head                               A   1.75   0.73     0.65     0.73     0.65     0.10   2.58   2.50   2.58   2.50  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70498  Ct angiography neck                               A   1.75  16.06    13.08    16.06NA  13.08 NA  0.11  17.92  14.94  17.92  14.94  1XXX.00.00.0040000             25.5217 090 88     14.00  14.00   0.11
70498TCCt angiography neck                               A   0.00  15.32    12.43    15.32NA  12.43 NA  0.01  15.33  12.44  15.33  12.44  1XXX.00.00.0040000             25.5217 020 88     13.26  13.26   0.01
7049826Ct angiography neck                               A   1.75   0.74     0.65     0.74     0.65     0.10   2.59   2.50   2.59   2.50  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70540  Mri orbit/face/neck w/o dye                       A   1.35  13.38    10.35    13.38NA  10.35 NA  0.09  14.82  11.79  14.82  11.79  1XXX.00.00.0040000             25.5217 090 88     13.98  13.98   0.09
70540TCMri orbit/face/neck w/o dye                       A   0.00  12.83     9.85    12.83NA   9.85 NA  0.01  12.84   9.86  12.84   9.86  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7054026Mri orbit/face/neck w/o dye                       A   1.35   0.55     0.50     0.55     0.50     0.08   1.98   1.93   1.98   1.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70542  Mri orbit/face/neck w/dye                         A   1.62  14.85    11.64    14.85NA  11.64 NA  0.11  16.58  13.37  16.58  13.37  1XXX.00.00.0040000             25.5217 090 88     17.78  17.78   0.11
70542TCMri orbit/face/neck w/dye                         A   0.00  14.18    11.03    14.18NA  11.03 NA  0.01  14.19  11.04  14.19  11.04  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7054226Mri orbit/face/neck w/dye                         A   1.62   0.67     0.61     0.67     0.61     0.10   2.39   2.33   2.39   2.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70543  Mri orbt/fac/nck w/o & w/dye                      A   2.15  19.37    13.96    19.37NA  13.96 NA  0.13  21.65  16.24  21.65  16.24  1XXX.00.00.0040000             25.5217 090 88     21.78  21.78   0.13
70543TCMri orbt/fac/nck w/o & w/dye                      A   0.00  18.49    13.16    18.49NA  13.16 NA  0.01  18.50  13.17  18.50  13.17  1XXX.00.00.0040000             25.5217 020 88     20.90  20.90   0.01
7054326Mri orbt/fac/nck w/o & w/dye                      A   2.15   0.88     0.80     0.88     0.80     0.12   3.15   3.07   3.15   3.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70544  Mr angiography head w/o dye                       A   1.20  14.93    11.97    14.93NA  11.97 NA  0.08  16.21  13.25  16.21  13.25  1XXX.00.00.0040000             25.5217 090 88     13.92  13.92   0.08
70544TCMr angiography head w/o dye                       A   0.00  14.44    11.52    14.44NA  11.52 NA  0.01  14.45  11.53  14.45  11.53  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7054426Mr angiography head w/o dye                       A   1.20   0.49     0.45     0.49     0.45     0.07   1.76   1.72   1.76   1.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70545  Mr angiography head w/dye                         A   1.20  14.83    11.86    14.83NA  11.86 NA  0.08  16.11  13.14  16.11  13.14  1XXX.00.00.0040000             25.5217 090 88     17.60  17.60   0.08
70545TCMr angiography head w/dye                         A   0.00  14.34    11.41    14.34NA  11.41 NA  0.01  14.35  11.42  14.35  11.42  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7054526Mr angiography head w/dye                         A   1.20   0.49     0.45     0.49     0.45     0.07   1.76   1.72   1.76   1.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70546  Mr angiograph head w/o&w/dye                      A   1.80  23.45    18.13    23.45NA  18.13 NA  0.12  25.37  20.05  25.37  20.05  1XXX.00.00.0040000             25.5217 090 88     21.64  21.64   0.12
70546TCMr angiograph head w/o&w/dye                      A   0.00  22.71    17.45    22.71NA  17.45 NA  0.01  22.72  17.46  22.72  17.46  1XXX.00.00.0040000             25.5217 020 88     20.90  20.90   0.01
7054626Mr angiograph head w/o&w/dye                      A   1.80   0.74     0.68     0.74     0.68     0.11   2.65   2.59   2.65   2.59  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70547  Mr angiography neck w/o dye                       A   1.20  14.91    11.96    14.91NA  11.96 NA  0.08  16.19  13.24  16.19  13.24  1XXX.00.00.0040000             25.5217 090 88     13.93  13.93   0.08
70547TCMr angiography neck w/o dye                       A   0.00  14.41    11.51    14.41NA  11.51 NA  0.01  14.42  11.52  14.42  11.52  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7054726Mr angiography neck w/o dye                       A   1.20   0.50     0.45     0.50     0.45     0.07   1.77   1.72   1.77   1.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70548  Mr angiography neck w/dye                         A   1.20  15.71    12.77    15.71NA  12.77 NA  0.08  16.99  14.05  16.99  14.05  1XXX.00.00.0040000             25.5217 090 88     17.61  17.61   0.08
70548TCMr angiography neck w/dye                         A   0.00  15.21    12.32    15.21NA  12.32 NA  0.01  15.22  12.33  15.22  12.33  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7054826Mr angiography neck w/dye                         A   1.20   0.50     0.45     0.50     0.45     0.07   1.77   1.72   1.77   1.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70549  Mr angiograph neck w/o&w/dye                      A   1.80  23.47    18.14    23.47NA  18.14 NA  0.11  25.38  20.05  25.38  20.05  1XXX.00.00.0040000             25.5217 090 88     21.64  21.64   0.11
70549TCMr angiograph neck w/o&w/dye                      A   0.00  22.73    17.47    22.73NA  17.47 NA  0.01  22.74  17.48  22.74  17.48  1XXX.00.00.0040000             25.5217 020 88     20.90  20.90   0.01
7054926Mr angiograph neck w/o&w/dye                      A   1.80   0.74     0.67     0.74     0.67     0.10   2.64   2.57   2.64   2.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70551  Mri brain w/o dye                                 A   1.48  13.76    10.84    13.76NA  10.84 NA  0.09  15.33  12.41  15.33  12.41  1XXX.00.00.0040000             25.5217 090 88     14.04  14.04   0.09
70551TCMri brain w/o dye                                 A   0.00  13.15    10.28    13.15NA  10.28 NA  0.01  13.16  10.29  13.16  10.29  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7055126Mri brain w/o dye                                 A   1.48   0.61     0.56     0.61     0.56     0.08   2.17   2.12   2.17   2.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70552  Mri brain w/dye                                   A   1.78  15.21    11.97    15.21NA  11.97 NA  0.12  17.11  13.87  17.11  13.87  1XXX.00.00.0040000             25.5217 090 88     17.85  17.85   0.12
70552TCMri brain w/dye                                   A   0.00  14.47    11.30    14.47NA  11.30 NA  0.01  14.48  11.31  14.48  11.31  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7055226Mri brain w/dye                                   A   1.78   0.74     0.67     0.74     0.67     0.11   2.63   2.56   2.63   2.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70553  Mri brain w/o & w/dye                             A   2.36  19.00    13.74    19.00NA  13.74 NA  0.15  21.51  16.25  21.51  16.25  1XXX.00.00.0040000             25.5217 090 88     21.88  21.88   0.15
70553TCMri brain w/o & w/dye                             A   0.00  18.02    12.86    18.02NA  12.86 NA  0.01  18.03  12.87  18.03  12.87  1XXX.00.00.0040000             25.5217 020 88     20.90  20.90   0.01
7055326Mri brain w/o & w/dye                             A   2.36   0.98     0.88     0.98     0.88     0.14   3.48   3.38   3.48   3.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70554  Fmri brain by tech                                A   2.11  14.68    12.07    14.68NA  12.07 NA  0.13  16.92  14.31  16.92  14.31  1XXX.00.00.0043000             25.5217 090 88      0.00   0.00   0.00
70554TCFmri brain by tech                                A   0.00  13.78    11.25    13.78NA  11.25 NA  0.01  13.79  11.26  13.79  11.26  1XXX.00.00.0043000             25.5217 020 88      0.00   0.00   0.00
7055426Fmri brain by tech                                A   2.11   0.90     0.82     0.90     0.82     0.12   3.13   3.05   3.13   3.05  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
70555  Fmri brain by phys/psych                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
70555TCFmri brain by phys/psych                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0003000             25.5217 020 99      0.00   0.00   0.00
7055526Fmri brain by phys/psych                          A   2.54   1.06     0.93     1.06     0.93     0.24   3.84   3.71   3.84   3.71  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
70557  Mri brain w/o dye                                 C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     14.94  14.94   1.06
70557TCMri brain w/o dye                                 C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     13.43  13.43   0.01
7055726Mri brain w/o dye                                 A   2.90   1.51     1.62     1.51     1.62     1.05   5.46   5.57   5.46   5.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70558  Mri brain w/dye                                   C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     18.44  18.44   0.31
70558TCMri brain w/dye                                   C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 020 99     17.11  17.11   0.01
7055826Mri brain w/dye                                   A   3.20   1.33     1.21     1.33     1.21     0.30   4.83   4.71   4.83   4.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
70559  Mri brain w/o & w/dye                             C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     22.29  22.29   0.31
70559TCMri brain w/o & w/dye                             C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 020 99     20.90  20.90   0.01
7055926Mri brain w/o & w/dye                             A   3.20   1.39     1.25     1.39     1.25     0.30   4.89   4.75   4.89   4.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71010  Chest x-ray                                       A   0.18   0.50     0.46     0.50NA   0.46 NA  0.02   0.70   0.66   0.70   0.66  1XXX.00.00.0000000             25.5217 090 99      1.79   1.79   0.05
71010TCChest x-ray                                       A   0.00   0.43     0.39     0.43NA   0.39 NA  0.01   0.44   0.40   0.44   0.40  1XXX.00.00.0000000             25.5217 010 99      1.72   1.72   0.04
7101026Chest x-ray                                       A   0.18   0.07     0.07     0.07     0.07     0.01   0.26   0.26   0.26   0.26  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71015  Chest x-ray                                       A   0.21   0.67     0.62     0.67NA   0.62 NA  0.02   0.90   0.85   0.90   0.85  1XXX.00.00.0000000             25.5217 090 99      1.82   1.82   0.04
71015TCChest x-ray                                       A   0.00   0.58     0.54     0.58NA   0.54 NA  0.01   0.59   0.55   0.59   0.55  1XXX.00.00.0000000             25.5217 010 99      1.73   1.73   0.03
7101526Chest x-ray                                       A   0.21   0.09     0.08     0.09     0.08     0.01   0.31   0.30   0.31   0.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71020  Chest x-ray                                       A   0.22   0.68     0.62     0.68NA   0.62 NA  0.02   0.92   0.86   0.92   0.86  1XXX.00.00.0000000             25.5217 090 99      1.83   1.83   0.04
71020TCChest x-ray                                       A   0.00   0.59     0.53     0.59NA   0.53 NA  0.01   0.60   0.54   0.60   0.54  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7102026Chest x-ray                                       A   0.22   0.09     0.09     0.09     0.09     0.01   0.32   0.32   0.32   0.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71021  Chest x-ray                                       A   0.27   0.85     0.79     0.85NA   0.79 NA  0.02   1.14   1.08   1.14   1.08  1XXX.00.00.0000000             25.5217 090 99      1.86   1.86   0.03
71021TCChest x-ray                                       A   0.00   0.73     0.67     0.73NA   0.67 NA  0.01   0.74   0.68   0.74   0.68  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7102126Chest x-ray                                       A   0.27   0.12     0.12     0.12     0.12     0.01   0.40   0.40   0.40   0.40  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71022  Chest x-ray                                       A   0.31   1.05     1.00     1.05NA   1.00 NA  0.02   1.38   1.33   1.38   1.33  1XXX.00.00.0000000             25.5217 090 99      1.88   1.88   0.03
71022TCChest x-ray                                       A   0.00   0.92     0.87     0.92NA   0.87 NA  0.01   0.93   0.88   0.93   0.88  1XXX.00.00.0000000             25.5217 010 99      1.75   1.75   0.02
7102226Chest x-ray                                       A   0.31   0.13     0.13     0.13     0.13     0.01   0.45   0.45   0.45   0.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71023  Chest x-ray and fluoroscopy                       A   0.38   1.66     1.60     1.66NA   1.60 NA  0.02   2.06   2.00   2.06   2.00  1XXX.00.00.0000000             25.5217 090 99      3.42   3.42   0.03
71023TCChest x-ray and fluoroscopy                       A   0.00   1.49     1.45     1.49NA   1.45 NA  0.01   1.50   1.46   1.50   1.46  1XXX.00.00.0000000             25.5217 030 99      3.25   3.25   0.02
7102326Chest x-ray and fluoroscopy                       A   0.38   0.17     0.15     0.17     0.15     0.01   0.56   0.54   0.56   0.54  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71030  Chest x-ray                                       A   0.31   1.04     0.96     1.04NA   0.96 NA  0.02   1.37   1.29   1.37   1.29  1XXX.00.00.0000000             25.5217 090 99      1.88   1.88   0.03
71030TCChest x-ray                                       A   0.00   0.91     0.84     0.91NA   0.84 NA  0.01   0.92   0.85   0.92   0.85  1XXX.00.00.0000000             25.5217 010 99      1.75   1.75   0.02
7103026Chest x-ray                                       A   0.31   0.13     0.12     0.13     0.12     0.01   0.45   0.44   0.45   0.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71034  Chest x-ray and fluoroscopy                       A   0.46   2.15     1.91     2.15NA   1.91 NA  0.02   2.63   2.39   2.63   2.39  1XXX.00.00.0000000             25.5217 090 99      3.47   3.47   0.03
71034TCChest x-ray and fluoroscopy                       A   0.00   1.93     1.73     1.93NA   1.73 NA  0.01   1.94   1.74   1.94   1.74  1XXX.00.00.0000000             25.5217 030 99      3.25   3.25   0.02
7103426Chest x-ray and fluoroscopy                       A   0.46   0.22     0.18     0.22     0.18     0.01   0.69   0.65   0.69   0.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71035  Chest x-ray                                       A   0.18   0.86     0.81     0.86NA   0.81 NA  0.02   1.06   1.01   1.06   1.01  1XXX.00.00.0000000             25.5217 090 99      1.82   1.82   0.03
71035TCChest x-ray                                       A   0.00   0.78     0.74     0.78NA   0.74 NA  0.01   0.79   0.75   0.79   0.75  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7103526Chest x-ray                                       A   0.18   0.08     0.07     0.08     0.07     0.01   0.27   0.26   0.27   0.26  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71040  Contrast x-ray of bronchi                         A   0.58   2.27     2.15     2.27NA   2.15 NA  0.02   2.87   2.75   2.87   2.75  1XXX.00.00.0000000             25.5217 090 99      9.21   9.21   0.05
71040TCContrast x-ray of bronchi                         A   0.00   2.03     1.94     2.03NA   1.94 NA  0.01   2.04   1.95   2.04   1.95  1XXX.00.00.0000000             25.5217 030 99      8.97   8.97   0.04
7104026Contrast x-ray of bronchi                         A   0.58   0.24     0.21     0.24     0.21     0.01   0.83   0.80   0.83   0.80  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71060  Contrast x-ray of bronchi                         A   0.74   3.41     3.23     3.41NA   3.23 NA  0.05   4.20   4.02   4.20   4.02  1XXX.00.00.0002000             25.5217 090 99      9.28   9.28   0.07
71060TCContrast x-ray of bronchi                         A   0.00   3.11     2.95     3.11NA   2.95 NA  0.01   3.12   2.96   3.12   2.96  1XXX.00.00.0002000             25.5217 030 99      8.98   8.98   0.03
7106026Contrast x-ray of bronchi                         A   0.74   0.30     0.28     0.30     0.28     0.04   1.08   1.06   1.08   1.06  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
71090  X-ray & pacemaker insertion                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71090TCX-ray & pacemaker insertion                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7109026X-ray & pacemaker insertion                       A   0.54   0.26     0.21     0.26     0.21     0.04   0.84   0.79   0.84   0.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71100  X-ray exam of ribs                                A   0.22   0.73     0.69     0.73NA   0.69 NA  0.02   0.97   0.93   0.97   0.93  1XXX.00.00.0000000             25.5217 090 99      1.83   1.83   0.04
71100TCX-ray exam of ribs                                A   0.00   0.64     0.60     0.64NA   0.60 NA  0.01   0.65   0.61   0.65   0.61  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7110026X-ray exam of ribs                                A   0.22   0.09     0.09     0.09     0.09     0.01   0.32   0.32   0.32   0.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71101  X-ray exam of ribs/chest                          A   0.27   0.89     0.84     0.89NA   0.84 NA  0.02   1.18   1.13   1.18   1.13  1XXX.00.00.0000000             25.5217 090 99      1.85   1.85   0.03
71101TCX-ray exam of ribs/chest                          A   0.00   0.78     0.73     0.78NA   0.73 NA  0.01   0.79   0.74   0.79   0.74  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7110126X-ray exam of ribs/chest                          A   0.27   0.11     0.11     0.11     0.11     0.01   0.39   0.39   0.39   0.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71110  X-ray exam of ribs                                A   0.27   0.92     0.88     0.92NA   0.88 NA  0.02   1.21   1.17   1.21   1.17  1XXX.00.00.0002000             25.5217 090 99      1.85   1.85   0.03
71110TCX-ray exam of ribs                                A   0.00   0.81     0.76     0.81NA   0.76 NA  0.01   0.82   0.77   0.82   0.77  1XXX.00.00.0002000             25.5217 010 99      1.74   1.74   0.02
7111026X-ray exam of ribs                                A   0.27   0.11     0.12     0.11     0.12     0.01   0.39   0.40   0.39   0.40  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
71111  X-ray exam of ribs/chest                          A   0.32   1.23     1.19     1.23NA   1.19 NA  0.02   1.57   1.53   1.57   1.53  1XXX.00.00.0002000             25.5217 090 99      3.09   3.09   0.04
71111TCX-ray exam of ribs/chest                          A   0.00   1.09     1.05     1.09NA   1.05 NA  0.01   1.10   1.06   1.10   1.06  1XXX.00.00.0002000             25.5217 010 99      2.95   2.95   0.03
7111126X-ray exam of ribs/chest                          A   0.32   0.14     0.14     0.14     0.14     0.01   0.47   0.47   0.47   0.47  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
71120  X-ray exam of breastbone                          A   0.20   0.73     0.67     0.73NA   0.67 NA  0.02   0.95   0.89   0.95   0.89  1XXX.00.00.0000000             25.5217 090 99      1.82   1.82   0.04
71120TCX-ray exam of breastbone                          A   0.00   0.65     0.59     0.65NA   0.59 NA  0.01   0.66   0.60   0.66   0.60  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7112026X-ray exam of breastbone                          A   0.20   0.08     0.08     0.08     0.08     0.01   0.29   0.29   0.29   0.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71130  X-ray exam of breastbone                          A   0.22   0.87     0.82     0.87NA   0.82 NA  0.02   1.11   1.06   1.11   1.06  1XXX.00.00.0000000             25.5217 090 99      1.83   1.83   0.03
71130TCX-ray exam of breastbone                          A   0.00   0.78     0.73     0.78NA   0.73 NA  0.01   0.79   0.74   0.79   0.74  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7113026X-ray exam of breastbone                          A   0.22   0.09     0.09     0.09     0.09     0.01   0.32   0.32   0.32   0.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71250  Ct thorax w/o dye                                 A   1.00   6.38     4.97     6.38NA   4.97 NA  0.07   7.45   6.04   7.45   6.04  1XXX.00.00.0040000             25.5217 090 88      8.03   8.03   0.07
71250TCCt thorax w/o dye                                 A   0.00   5.93     4.59     5.93NA   4.59 NA  0.01   5.94   4.60   5.94   4.60  1XXX.00.00.0040000             25.5217 010 88      7.58   7.58   0.01
7125026Ct thorax w/o dye                                 A   1.00   0.45     0.38     0.45     0.38     0.06   1.51   1.44   1.51   1.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71260  Ct thorax w/dye                                   A   1.24   7.90     6.24     7.90NA   6.24 NA  0.08   9.22   7.56   9.22   7.56  1XXX.00.00.0040000             25.5217 090 88     12.25  12.25   0.09
71260TCCt thorax w/dye                                   A   0.00   7.38     5.77     7.38NA   5.77 NA  0.01   7.39   5.78   7.39   5.78  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.02
7126026Ct thorax w/dye                                   A   1.24   0.52     0.47     0.52     0.47     0.07   1.83   1.78   1.83   1.78  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71270  Ct thorax w/o & w/dye                             A   1.38   9.86     7.73     9.86NA   7.73 NA  0.08  11.32   9.19  11.32   9.19  1XXX.00.00.0040000             25.5217 090 88     13.65  13.65   0.08
71270TCCt thorax w/o & w/dye                             A   0.00   9.29     7.21     9.29NA   7.21 NA  0.01   9.30   7.22   9.30   7.22  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.01
7127026Ct thorax w/o & w/dye                             A   1.38   0.57     0.52     0.57     0.52     0.07   2.02   1.97   2.02   1.97  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71275  Ct angiography chest                              A   1.92  12.05     9.46    12.05NA   9.46 NA  0.12  14.09  11.50  14.09  11.50  1XXX.00.00.0040000             25.5217 090 88     14.05  14.05   0.12
71275TCCt angiography chest                              A   0.00  11.25     8.74    11.25NA   8.74 NA  0.01  11.26   8.75  11.26   8.75  1XXX.00.00.0040000             25.5217 020 88     13.25  13.25   0.01
7127526Ct angiography chest                              A   1.92   0.80     0.72     0.80     0.72     0.11   2.83   2.75   2.83   2.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71550  Mri chest w/o dye                                 A   1.46  15.21    12.02    15.21NA  12.02 NA  0.09  16.76  13.57  16.76  13.57  1XXX.00.00.0040000             25.5217 090 88     14.03  14.03   0.09
71550TCMri chest w/o dye                                 A   0.00  14.61    11.48    14.61NA  11.48 NA  0.01  14.62  11.49  14.62  11.49  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7155026Mri chest w/o dye                                 A   1.46   0.60     0.54     0.60     0.54     0.08   2.14   2.08   2.14   2.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71551  Mri chest w/dye                                   A   1.73  17.05    13.59    17.05NA  13.59 NA  0.11  18.89  15.43  18.89  15.43  1XXX.00.00.0040000             25.5217 090 88     17.82  17.82   0.11
71551TCMri chest w/dye                                   A   0.00  16.34    12.94    16.34NA  12.94 NA  0.01  16.35  12.95  16.35  12.95  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7155126Mri chest w/dye                                   A   1.73   0.71     0.65     0.71     0.65     0.10   2.54   2.48   2.54   2.48  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71552  Mri chest w/o & w/dye                             A   2.26  22.48    16.70    22.48NA  16.70 NA  0.13  24.87  19.09  24.87  19.09  1XXX.00.00.0040000             25.5217 090 88     21.84  21.84   0.13
71552TCMri chest w/o & w/dye                             A   0.00  21.54    15.86    21.54NA  15.86 NA  0.01  21.55  15.87  21.55  15.87  1XXX.00.00.0040000             25.5217 020 88     20.90  20.90   0.01
7155226Mri chest w/o & w/dye                             A   2.26   0.94     0.84     0.94     0.84     0.12   3.32   3.22   3.32   3.22  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
71555  Mri angio chest w or w/o dye                      R   1.81  14.53    11.59    14.53NA  11.59 NA  0.11  16.45  13.51  16.45  13.51  1XXX.00.00.0040000             25.5217 090 88     21.65  21.65   0.12
71555TCMri angio chest w or w/o dye                      R   0.00  13.77    10.91    13.77NA  10.91 NA  0.01  13.78  10.92  13.78  10.92  1XXX.00.00.0040000             25.5217 020 88     20.89  20.89   0.02
7155526Mri angio chest w or w/o dye                      R   1.81   0.76     0.68     0.76     0.68     0.10   2.67   2.59   2.67   2.59  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72010  X-ray exam of spine                               A   0.45   1.72     1.76     1.72NA   1.76 NA  0.04   2.21   2.25   2.21   2.25  1XXX.00.00.0000000             25.5217 090 99      3.14   3.14   0.05
72010TCX-ray exam of spine                               A   0.00   1.53     1.55     1.53NA   1.55 NA  0.01   1.54   1.56   1.54   1.56  1XXX.00.00.0000000             25.5217 010 99      2.95   2.95   0.02
7201026X-ray exam of spine                               A   0.45   0.19     0.21     0.19     0.21     0.03   0.67   0.69   0.67   0.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72020  X-ray exam of spine                               A   0.15   0.54     0.50     0.54NA   0.50 NA  0.02   0.71   0.67   0.71   0.67  1XXX.00.00.0000000             25.5217 090 99      1.80   1.80   0.05
72020TCX-ray exam of spine                               A   0.00   0.47     0.44     0.47NA   0.44 NA  0.01   0.48   0.45   0.48   0.45  1XXX.00.00.0000000             25.5217 010 99      1.73   1.73   0.04
7202026X-ray exam of spine                               A   0.15   0.07     0.06     0.07     0.06     0.01   0.23   0.22   0.23   0.22  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72040  X-ray exam of neck spine                          A   0.22   0.90     0.89     0.90NA   0.89 NA  0.04   1.16   1.15   1.16   1.15  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.05
72040TCX-ray exam of neck spine                          A   0.00   0.80     0.79     0.80NA   0.79 NA  0.01   0.81   0.80   0.81   0.80  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7204026X-ray exam of neck spine                          A   0.22   0.10     0.10     0.10     0.10     0.03   0.35   0.35   0.35   0.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72050  X-ray exam of neck spine                          A   0.31   1.23     1.16     1.23NA   1.16 NA  0.04   1.58   1.51   1.58   1.51  1XXX.00.00.0000000             25.5217 090 99      3.08   3.08   0.06
72050TCX-ray exam of neck spine                          A   0.00   1.10     1.04     1.10NA   1.04 NA  0.01   1.11   1.05   1.11   1.05  1XXX.00.00.0000000             25.5217 010 99      2.95   2.95   0.03
7205026X-ray exam of neck spine                          A   0.31   0.13     0.12     0.13     0.12     0.03   0.47   0.46   0.47   0.46  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72052  X-ray exam of neck spine                          A   0.36   1.61     1.55     1.61NA   1.55 NA  0.04   2.01   1.95   2.01   1.95  1XXX.00.00.0000000             25.5217 090 99      3.11   3.11   0.05
72052TCX-ray exam of neck spine                          A   0.00   1.45     1.40     1.45NA   1.40 NA  0.01   1.46   1.41   1.46   1.41  1XXX.00.00.0000000             25.5217 010 99      2.95   2.95   0.02
7205226X-ray exam of neck spine                          A   0.36   0.16     0.15     0.16     0.15     0.03   0.55   0.54   0.55   0.54  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72069  X-ray exam of trunk spine                         A   0.22   0.86     0.85     0.86NA   0.85 NA  0.04   1.12   1.11   1.12   1.11  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.05
72069TCX-ray exam of trunk spine                         A   0.00   0.76     0.75     0.76NA   0.75 NA  0.01   0.77   0.76   0.77   0.76  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7206926X-ray exam of trunk spine                         A   0.22   0.10     0.10     0.10     0.10     0.03   0.35   0.35   0.35   0.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72070  X-ray exam of thoracic spine                      A   0.22   0.77     0.73     0.77NA   0.73 NA  0.02   1.01   0.97   1.01   0.97  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.04
72070TCX-ray exam of thoracic spine                      A   0.00   0.67     0.63     0.67NA   0.63 NA  0.01   0.68   0.64   0.68   0.64  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7207026X-ray exam of thoracic spine                      A   0.22   0.10     0.10     0.10     0.10     0.01   0.33   0.33   0.33   0.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72072  X-ray exam of thoracic spine                      A   0.22   0.88     0.81     0.88NA   0.81 NA  0.02   1.12   1.05   1.12   1.05  1XXX.00.00.0000000             25.5217 090 99      1.83   1.83   0.03
72072TCX-ray exam of thoracic spine                      A   0.00   0.79     0.73     0.79NA   0.73 NA  0.01   0.80   0.74   0.80   0.74  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7207226X-ray exam of thoracic spine                      A   0.22   0.09     0.08     0.09     0.08     0.01   0.32   0.31   0.32   0.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72074  X-ray exam of thoracic spine                      A   0.22   1.09     1.01     1.09NA   1.01 NA  0.02   1.33   1.25   1.33   1.25  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.03
72074TCX-ray exam of thoracic spine                      A   0.00   1.00     0.92     1.00NA   0.92 NA  0.01   1.01   0.93   1.01   0.93  1XXX.00.00.0000000             25.5217 010 99      1.75   1.75   0.02
7207426X-ray exam of thoracic spine                      A   0.22   0.09     0.09     0.09     0.09     0.01   0.32   0.32   0.32   0.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72080  X-ray exam of trunk spine                         A   0.22   0.83     0.81     0.83NA   0.81 NA  0.04   1.09   1.07   1.09   1.07  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.05
72080TCX-ray exam of trunk spine                         A   0.00   0.73     0.71     0.73NA   0.71 NA  0.01   0.74   0.72   0.74   0.72  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7208026X-ray exam of trunk spine                         A   0.22   0.10     0.10     0.10     0.10     0.03   0.35   0.35   0.35   0.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72090  X-ray exam of trunk spine                         A   0.28   1.15     1.15     1.15NA   1.15 NA  0.05   1.48   1.48   1.48   1.48  1XXX.00.00.0000000             25.5217 090 99      3.07   3.07   0.07
72090TCX-ray exam of trunk spine                         A   0.00   1.02     1.02     1.02NA   1.02 NA  0.01   1.03   1.03   1.03   1.03  1XXX.00.00.0000000             25.5217 010 99      2.94   2.94   0.03
7209026X-ray exam of trunk spine                         A   0.28   0.13     0.13     0.13     0.13     0.04   0.45   0.45   0.45   0.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72100  X-ray exam of lower spine                         A   0.22   0.96     0.94     0.96NA   0.94 NA  0.04   1.22   1.20   1.22   1.20  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.05
72100TCX-ray exam of lower spine                         A   0.00   0.86     0.84     0.86NA   0.84 NA  0.01   0.87   0.85   0.87   0.85  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7210026X-ray exam of lower spine                         A   0.22   0.10     0.10     0.10     0.10     0.03   0.35   0.35   0.35   0.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72110  X-ray exam of lower spine                         A   0.31   1.30     1.26     1.30NA   1.26 NA  0.04   1.65   1.61   1.65   1.61  1XXX.00.00.0000000             25.5217 090 99      3.08   3.08   0.06
72110TCX-ray exam of lower spine                         A   0.00   1.17     1.13     1.17NA   1.13 NA  0.01   1.18   1.14   1.18   1.14  1XXX.00.00.0000000             25.5217 010 99      2.95   2.95   0.03
7211026X-ray exam of lower spine                         A   0.31   0.13     0.13     0.13     0.13     0.03   0.47   0.47   0.47   0.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72114  X-ray exam of lower spine                         A   0.36   1.81     1.78     1.81NA   1.78 NA  0.05   2.22   2.19   2.22   2.19  1XXX.00.00.0000000             25.5217 090 99      3.11   3.11   0.06
72114TCX-ray exam of lower spine                         A   0.00   1.65     1.62     1.65NA   1.62 NA  0.01   1.66   1.63   1.66   1.63  1XXX.00.00.0000000             25.5217 010 99      2.95   2.95   0.02
7211426X-ray exam of lower spine                         A   0.36   0.16     0.16     0.16     0.16     0.04   0.56   0.56   0.56   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72120  X-ray exam of lower spine                         A   0.22   1.28     1.29     1.28NA   1.29 NA  0.04   1.54   1.55   1.54   1.55  1XXX.00.00.0000000             25.5217 090 99      1.85   1.85   0.04
72120TCX-ray exam of lower spine                         A   0.00   1.18     1.18     1.18NA   1.18 NA  0.01   1.19   1.19   1.19   1.19  1XXX.00.00.0000000             25.5217 010 99      1.75   1.75   0.01
7212026X-ray exam of lower spine                         A   0.22   0.10     0.11     0.10     0.11     0.03   0.35   0.36   0.35   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72125  Ct neck spine w/o dye                             A   1.00   6.42     5.01     6.42NA   5.01 NA  0.07   7.49   6.08   7.49   6.08  1XXX.00.00.0040000             25.5217 090 88      8.03   8.03   0.07
72125TCCt neck spine w/o dye                             A   0.00   5.97     4.64     5.97NA   4.64 NA  0.01   5.98   4.65   5.98   4.65  1XXX.00.00.0040000             25.5217 010 88      7.58   7.58   0.01
7212526Ct neck spine w/o dye                             A   1.00   0.45     0.37     0.45     0.37     0.06   1.51   1.43   1.51   1.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72126  Ct neck spine w/dye                               A   1.22   7.90     6.26     7.90NA   6.26 NA  0.08   9.20   7.56   9.20   7.56  1XXX.00.00.0040000             25.5217 090 88     12.23  12.23   0.09
72126TCCt neck spine w/dye                               A   0.00   7.40     5.80     7.40NA   5.80 NA  0.01   7.41   5.81   7.41   5.81  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.02
7212626Ct neck spine w/dye                               A   1.22   0.50     0.46     0.50     0.46     0.07   1.79   1.75   1.79   1.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72127  Ct neck spine w/o & w/dye                         A   1.27   9.80     7.70     9.80NA   7.70 NA  0.08  11.15   9.05  11.15   9.05  1XXX.00.00.0040000             25.5217 090 88     13.60  13.60   0.08
72127TCCt neck spine w/o & w/dye                         A   0.00   9.28     7.23     9.28NA   7.23 NA  0.01   9.29   7.24   9.29   7.24  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.01
7212726Ct neck spine w/o & w/dye                         A   1.27   0.52     0.47     0.52     0.47     0.07   1.86   1.81   1.86   1.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72128  Ct chest spine w/o dye                            A   1.00   6.40     5.01     6.40NA   5.01 NA  0.07   7.47   6.08   7.47   6.08  1XXX.00.00.0040000             25.5217 090 88      8.03   8.03   0.07
72128TCCt chest spine w/o dye                            A   0.00   5.95     4.63     5.95NA   4.63 NA  0.01   5.96   4.64   5.96   4.64  1XXX.00.00.0040000             25.5217 010 88      7.58   7.58   0.01
7212826Ct chest spine w/o dye                            A   1.00   0.45     0.38     0.45     0.38     0.06   1.51   1.44   1.51   1.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72129  Ct chest spine w/dye                              A   1.22   7.92     6.28     7.92NA   6.28 NA  0.08   9.22   7.58   9.22   7.58  1XXX.00.00.0040000             25.5217 090 88     12.24  12.24   0.09
72129TCCt chest spine w/dye                              A   0.00   7.41     5.82     7.41NA   5.82 NA  0.01   7.42   5.83   7.42   5.83  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.02
7212926Ct chest spine w/dye                              A   1.22   0.51     0.46     0.51     0.46     0.07   1.80   1.75   1.80   1.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72130  Ct chest spine w/o & w/dye                        A   1.27   9.82     7.69     9.82NA   7.69 NA  0.08  11.17   9.04  11.17   9.04  1XXX.00.00.0040000             25.5217 090 88     13.61  13.61   0.08
72130TCCt chest spine w/o & w/dye                        A   0.00   9.29     7.22     9.29NA   7.22 NA  0.01   9.30   7.23   9.30   7.23  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.01
7213026Ct chest spine w/o & w/dye                        A   1.27   0.53     0.47     0.53     0.47     0.07   1.87   1.81   1.87   1.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72131  Ct lumbar spine w/o dye                           A   1.00   6.38     4.99     6.38NA   4.99 NA  0.07   7.45   6.06   7.45   6.06  1XXX.00.00.0040000             25.5217 090 88      8.03   8.03   0.07
72131TCCt lumbar spine w/o dye                           A   0.00   5.93     4.61     5.93NA   4.61 NA  0.01   5.94   4.62   5.94   4.62  1XXX.00.00.0040000             25.5217 010 88      7.58   7.58   0.01
7213126Ct lumbar spine w/o dye                           A   1.00   0.45     0.38     0.45     0.38     0.06   1.51   1.44   1.51   1.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72132  Ct lumbar spine w/dye                             A   1.22   7.90     6.25     7.90NA   6.25 NA  0.08   9.20   7.55   9.20   7.55  1XXX.00.00.0040000             25.5217 090 88     12.24  12.24   0.09
72132TCCt lumbar spine w/dye                             A   0.00   7.39     5.79     7.39NA   5.79 NA  0.01   7.40   5.80   7.40   5.80  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.02
7213226Ct lumbar spine w/dye                             A   1.22   0.51     0.46     0.51     0.46     0.07   1.80   1.75   1.80   1.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72133  Ct lumbar spine w/o & w/dye                       A   1.27   9.81     7.69     9.81NA   7.69 NA  0.08  11.16   9.04  11.16   9.04  1XXX.00.00.0040000             25.5217 090 88     13.61  13.61   0.08
72133TCCt lumbar spine w/o & w/dye                       A   0.00   9.28     7.21     9.28NA   7.21 NA  0.01   9.29   7.22   9.29   7.22  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.01
7213326Ct lumbar spine w/o & w/dye                       A   1.27   0.53     0.48     0.53     0.48     0.07   1.87   1.82   1.87   1.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72141  Mri neck spine w/o dye                            A   1.60  12.13     9.36    12.13NA   9.36 NA  0.11  13.84  11.07  13.84  11.07  1XXX.00.00.0040000             25.5217 090 88     14.09  14.09   0.11
72141TCMri neck spine w/o dye                            A   0.00  11.47     8.75    11.47NA   8.75 NA  0.01  11.48   8.76  11.48   8.76  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7214126Mri neck spine w/o dye                            A   1.60   0.66     0.61     0.66     0.61     0.10   2.36   2.31   2.36   2.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72142  Mri neck spine w/dye                              A   1.92  15.28    12.07    15.28NA  12.07 NA  0.12  17.32  14.11  17.32  14.11  1XXX.00.00.0040000             25.5217 090 88     17.91  17.91   0.12
72142TCMri neck spine w/dye                              A   0.00  14.48    11.33    14.48NA  11.33 NA  0.01  14.49  11.34  14.49  11.34  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7214226Mri neck spine w/dye                              A   1.92   0.80     0.74     0.80     0.74     0.11   2.83   2.77   2.83   2.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72146  Mri chest spine w/o dye                           A   1.60  12.33     9.38    12.33NA   9.38 NA  0.11  14.04  11.09  14.04  11.09  1XXX.00.00.0040000             25.5217 090 88     14.09  14.09   0.11
72146TCMri chest spine w/o dye                           A   0.00  11.67     8.77    11.67NA   8.77 NA  0.01  11.68   8.78  11.68   8.78  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7214626Mri chest spine w/o dye                           A   1.60   0.66     0.61     0.66     0.61     0.10   2.36   2.31   2.36   2.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72147  Mri chest spine w/dye                             A   1.92  13.58    10.52    13.58NA  10.52 NA  0.12  15.62  12.56  15.62  12.56  1XXX.00.00.0040000             25.5217 090 88     17.91  17.91   0.12
72147TCMri chest spine w/dye                             A   0.00  12.78     9.79    12.78NA   9.79 NA  0.01  12.79   9.80  12.79   9.80  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7214726Mri chest spine w/dye                             A   1.92   0.80     0.73     0.80     0.73     0.11   2.83   2.76   2.83   2.76  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72148  Mri lumbar spine w/o dye                          A   1.48  12.26     9.31    12.26NA   9.31 NA  0.11  13.85  10.90  13.85  10.90  1XXX.00.00.0040000             25.5217 090 88     14.04  14.04   0.11
72148TCMri lumbar spine w/o dye                          A   0.00  11.65     8.74    11.65NA   8.74 NA  0.01  11.66   8.75  11.66   8.75  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7214826Mri lumbar spine w/o dye                          A   1.48   0.61     0.57     0.61     0.57     0.10   2.19   2.15   2.19   2.15  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72149  Mri lumbar spine w/dye                            A   1.78  15.14    11.85    15.14NA  11.85 NA  0.12  17.04  13.75  17.04  13.75  1XXX.00.00.0040000             25.5217 090 88     17.86  17.86   0.12
72149TCMri lumbar spine w/dye                            A   0.00  14.39    11.17    14.39NA  11.17 NA  0.01  14.40  11.18  14.40  11.18  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7214926Mri lumbar spine w/dye                            A   1.78   0.75     0.68     0.75     0.68     0.11   2.64   2.57   2.64   2.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72156  Mri neck spine w/o & w/dye                        A   2.57  18.76    13.54    18.76NA  13.54 NA  0.17  21.50  16.28  21.50  16.28  1XXX.00.00.0040000             25.5217 090 88     21.96  21.96   0.17
72156TCMri neck spine w/o & w/dye                        A   0.00  17.70    12.57    17.70NA  12.57 NA  0.01  17.71  12.58  17.71  12.58  1XXX.00.00.0040000             25.5217 020 88     20.90  20.90   0.01
7215626Mri neck spine w/o & w/dye                        A   2.57   1.06     0.97     1.06     0.97     0.16   3.79   3.70   3.79   3.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72157  Mri chest spine w/o & w/dye                       A   2.57  17.49    12.42    17.49NA  12.42 NA  0.17  20.23  15.16  20.23  15.16  1XXX.00.00.0040000             25.5217 090 88     21.95  21.95   0.17
72157TCMri chest spine w/o & w/dye                       A   0.00  16.43    11.46    16.43NA  11.46 NA  0.01  16.44  11.47  16.44  11.47  1XXX.00.00.0040000             25.5217 020 88     20.89  20.89   0.01
7215726Mri chest spine w/o & w/dye                       A   2.57   1.06     0.96     1.06     0.96     0.16   3.79   3.69   3.79   3.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72158  Mri lumbar spine w/o & w/dye                      A   2.36  18.64    13.41    18.64NA  13.41 NA  0.17  21.17  15.94  21.17  15.94  1XXX.00.00.0040000             25.5217 090 88     21.87  21.87   0.17
72158TCMri lumbar spine w/o & w/dye                      A   0.00  17.67    12.52    17.67NA  12.52 NA  0.01  17.68  12.53  17.68  12.53  1XXX.00.00.0040000             25.5217 020 88     20.90  20.90   0.01
7215826Mri lumbar spine w/o & w/dye                      A   2.36   0.97     0.89     0.97     0.89     0.16   3.49   3.41   3.49   3.41  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72159  Mr angio spine w/o&w/dye                          R   1.80  16.30    13.68    16.30NA  13.68 NA  0.08  18.18  15.56  18.18  15.56  1XXX.00.00.0040000             25.5217 090 88     21.67  21.67   0.08
72159TCMr angio spine w/o&w/dye                          R   0.00  15.52    12.89    15.52NA  12.89 NA  0.01  15.53  12.90  15.53  12.90  1XXX.00.00.0040900             25.5217 020 88     20.89  20.89   0.01
7215926Mr angio spine w/o&w/dye                          R   1.80   0.78     0.79     0.78     0.79     0.07   2.65   2.66   2.65   2.66  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72170  X-ray exam of pelvis                              A   0.17   0.60     0.57     0.60NA   0.57 NA  0.04   0.81   0.78   0.81   0.78  1XXX.00.00.0000000             25.5217 090 99      1.81   1.81   0.06
72170TCX-ray exam of pelvis                              A   0.00   0.52     0.49     0.52NA   0.49 NA  0.01   0.53   0.50   0.53   0.50  1XXX.00.00.0000000             25.5217 010 99      1.73   1.73   0.03
7217026X-ray exam of pelvis                              A   0.17   0.08     0.08     0.08     0.08     0.03   0.28   0.28   0.28   0.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72190  X-ray exam of pelvis                              A   0.21   1.00     0.99     1.00NA   0.99 NA  0.04   1.25   1.24   1.25   1.24  1XXX.00.00.0000000             25.5217 090 99      1.85   1.85   0.05
72190TCX-ray exam of pelvis                              A   0.00   0.90     0.89     0.90NA   0.89 NA  0.01   0.91   0.90   0.91   0.90  1XXX.00.00.0000000             25.5217 010 99      1.75   1.75   0.02
7219026X-ray exam of pelvis                              A   0.21   0.10     0.10     0.10     0.10     0.03   0.34   0.34   0.34   0.34  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72191  Ct angiograph pelv w/o&w/dye                      A   1.81  11.56     8.98    11.56NA   8.98 NA  0.13  13.50  10.92  13.50  10.92  1XXX.00.00.0040000             25.5217 090 88     14.00  14.00   0.13
72191TCCt angiograph pelv w/o&w/dye                      A   0.00  10.81     8.31    10.81NA   8.31 NA  0.01  10.82   8.32  10.82   8.32  1XXX.00.00.0040000             25.5217 020 88     13.25  13.25   0.01
7219126Ct angiograph pelv w/o&w/dye                      A   1.81   0.75     0.67     0.75     0.67     0.12   2.68   2.60   2.68   2.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72192  Ct pelvis w/o dye                                 A   1.09   6.06     4.71     6.06NA   4.71 NA  0.06   7.21   5.86   7.21   5.86  1XXX.00.00.0040000             25.5217 090 88      8.04   8.04   0.06
72192TCCt pelvis w/o dye                                 A   0.00   5.60     4.30     5.60NA   4.30 NA  0.01   5.61   4.31   5.61   4.31  1XXX.00.00.0040000             25.5217 010 88      7.58   7.58   0.01
7219226Ct pelvis w/o dye                                 A   1.09   0.46     0.41     0.46     0.41     0.05   1.60   1.55   1.60   1.55  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72193  Ct pelvis w/dye                                   A   1.16   7.49     5.89     7.49NA   5.89 NA  0.08   8.73   7.13   8.73   7.13  1XXX.00.00.0040000             25.5217 090 88     12.21  12.21   0.09
72193TCCt pelvis w/dye                                   A   0.00   7.01     5.46     7.01NA   5.46 NA  0.01   7.02   5.47   7.02   5.47  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.02
7219326Ct pelvis w/dye                                   A   1.16   0.48     0.43     0.48     0.43     0.07   1.71   1.66   1.71   1.66  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72194  Ct pelvis w/o & w/dye                             A   1.22   9.88     7.83     9.88NA   7.83 NA  0.08  11.18   9.13  11.18   9.13  1XXX.00.00.0040000             25.5217 090 88     13.58  13.58   0.08
72194TCCt pelvis w/o & w/dye                             A   0.00   9.38     7.37     9.38NA   7.37 NA  0.01   9.39   7.38   9.39   7.38  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.01
7219426Ct pelvis w/o & w/dye                             A   1.22   0.50     0.46     0.50     0.46     0.07   1.79   1.75   1.79   1.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72195  Mri pelvis w/o dye                                A   1.46  13.68    10.73    13.68NA  10.73 NA  0.11  15.25  12.30  15.25  12.30  1XXX.00.00.0040000             25.5217 090 88     14.03  14.03   0.11
72195TCMri pelvis w/o dye                                A   0.00  13.08    10.17    13.08NA  10.17 NA  0.01  13.09  10.18  13.09  10.18  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7219526Mri pelvis w/o dye                                A   1.46   0.60     0.56     0.60     0.56     0.10   2.16   2.12   2.16   2.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72196  Mri pelvis w/dye                                  A   1.73  15.05    11.81    15.05NA  11.81 NA  0.11  16.89  13.65  16.89  13.65  1XXX.00.00.0040000             25.5217 090 88     17.83  17.83   0.11
72196TCMri pelvis w/dye                                  A   0.00  14.33    11.15    14.33NA  11.15 NA  0.01  14.34  11.16  14.34  11.16  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7219626Mri pelvis w/dye                                  A   1.73   0.72     0.66     0.72     0.66     0.10   2.55   2.49   2.55   2.49  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72197  Mri pelvis w/o & w/dye                            A   2.26  19.61    14.23    19.61NA  14.23 NA  0.13  22.00  16.62  22.00  16.62  1XXX.00.00.0040000             25.5217 090 88     21.83  21.83   0.13
72197TCMri pelvis w/o & w/dye                            A   0.00  18.68    13.39    18.68NA  13.39 NA  0.01  18.69  13.40  18.69  13.40  1XXX.00.00.0040000             25.5217 020 88     20.90  20.90   0.01
7219726Mri pelvis w/o & w/dye                            A   2.26   0.93     0.84     0.93     0.84     0.12   3.31   3.22   3.31   3.22  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72198  Mr angio pelvis w/o & w/dye                       A   1.80  14.47    11.58    14.47NA  11.58 NA  0.11  16.38  13.49  16.38  13.49  1XXX.00.00.0040000             25.5217 090 88     21.63  21.63   0.12
72198TCMr angio pelvis w/o & w/dye                       A   0.00  13.73    10.91    13.73NA  10.91 NA  0.01  13.74  10.92  13.74  10.92  1XXX.00.00.0040000             25.5217 020 88     20.89  20.89   0.02
7219826Mr angio pelvis w/o & w/dye                       A   1.80   0.74     0.67     0.74     0.67     0.10   2.64   2.57   2.64   2.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72200  X-ray exam sacroiliac joints                      A   0.17   0.69     0.66     0.69NA   0.66 NA  0.02   0.88   0.85   0.88   0.85  1XXX.00.00.0000000             25.5217 090 99      1.81   1.81   0.04
72200TCX-ray exam sacroiliac joints                      A   0.00   0.62     0.59     0.62NA   0.59 NA  0.01   0.63   0.60   0.63   0.60  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7220026X-ray exam sacroiliac joints                      A   0.17   0.07     0.07     0.07     0.07     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72202  X-ray exam sacroiliac joints                      A   0.19   0.83     0.77     0.83NA   0.77 NA  0.02   1.04   0.98   1.04   0.98  1XXX.00.00.0000000             25.5217 090 99      1.82   1.82   0.03
72202TCX-ray exam sacroiliac joints                      A   0.00   0.75     0.70     0.75NA   0.70 NA  0.01   0.76   0.71   0.76   0.71  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7220226X-ray exam sacroiliac joints                      A   0.19   0.08     0.07     0.08     0.07     0.01   0.28   0.27   0.28   0.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72220  X-ray exam of tailbone                            A   0.17   0.68     0.64     0.68NA   0.64 NA  0.02   0.87   0.83   0.87   0.83  1XXX.00.00.0000000             25.5217 090 99      1.81   1.81   0.04
72220TCX-ray exam of tailbone                            A   0.00   0.61     0.57     0.61NA   0.57 NA  0.01   0.62   0.58   0.62   0.58  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.03
7222026X-ray exam of tailbone                            A   0.17   0.07     0.07     0.07     0.07     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72240  Contrast x-ray of neck spine                      A   0.91   3.33     2.74     3.33NA   2.74 NA  0.06   4.30   3.71   4.30   3.71  1XXX.00.00.0000000             25.5217 090 99     19.87  19.87   0.12
72240TCContrast x-ray of neck spine                      A   0.00   2.95     2.39     2.95NA   2.39 NA  0.01   2.96   2.40   2.96   2.40  1XXX.00.00.0000000             25.5217 030 99     19.49  19.49   0.07
7224026Contrast x-ray of neck spine                      A   0.91   0.38     0.35     0.38     0.35     0.05   1.34   1.31   1.34   1.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72255  Contrast x-ray thorax spine                       A   0.91   3.07     2.66     3.07NA   2.66 NA  0.05   4.03   3.62   4.03   3.62  1XXX.00.00.0000000             25.5217 090 99     19.85  19.85   0.11
72255TCContrast x-ray thorax spine                       A   0.00   2.70     2.29     2.70NA   2.29 NA  0.01   2.71   2.30   2.71   2.30  1XXX.00.00.0000000             25.5217 030 99     19.48  19.48   0.07
7225526Contrast x-ray thorax spine                       A   0.91   0.37     0.37     0.37     0.37     0.04   1.32   1.32   1.32   1.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72265  Contrast x-ray lower spine                        A   0.83   3.21     2.76     3.21NA   2.76 NA  0.05   4.09   3.64   4.09   3.64  1XXX.00.00.0000000             25.5217 090 99     19.84  19.84   0.11
72265TCContrast x-ray lower spine                        A   0.00   2.86     2.43     2.86NA   2.43 NA  0.01   2.87   2.44   2.87   2.44  1XXX.00.00.0000000             25.5217 030 99     19.49  19.49   0.07
7226526Contrast x-ray lower spine                        A   0.83   0.35     0.33     0.35     0.33     0.04   1.22   1.20   1.22   1.20  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72270  Contrast x-ray spine                              A   1.33   4.97     4.26     4.97NA   4.26 NA  0.08   6.38   5.67   6.38   5.67  1XXX.00.00.0000000             25.5217 090 99     20.07  20.07   0.11
72270TCContrast x-ray spine                              A   0.00   4.41     3.75     4.41NA   3.75 NA  0.01   4.42   3.76   4.42   3.76  1XXX.00.00.0000000             25.5217 030 99     19.51  19.51   0.04
7227026Contrast x-ray spine                              A   1.33   0.56     0.51     0.56     0.51     0.07   1.96   1.91   1.96   1.91  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72275  Epidurography                                     A   0.76   2.50     2.68     2.50NA   2.68 NA  0.05   3.31   3.49   3.31   3.49  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
72275TCEpidurography                                     A   0.00   2.18     2.30     2.18NA   2.30 NA  0.01   2.19   2.31   2.19   2.31  1XXX.00.00.0099999             25.5217 030 99      0.00   0.00   0.00
7227526Epidurography                                     A   0.76   0.32     0.38     0.32     0.38     0.04   1.12   1.18   1.12   1.18  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
72285  X-ray c/t spine disk                              A   1.16   3.15     2.28     3.15NA   2.28 NA  0.06   4.37   3.50   4.37   3.50  1XXX.00.00.0000000             25.5217 090 99     65.79  65.79   0.30
72285TCX-ray c/t spine disk                              A   0.00   2.64     1.67     2.64NA   1.67 NA  0.01   2.65   1.68   2.65   1.68  1XXX.00.00.0000000             25.5217 030 99     65.28  65.28   0.25
7228526X-ray c/t spine disk                              A   1.16   0.51     0.61     0.51     0.61     0.05   1.72   1.82   1.72   1.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72291  Perq verte/sacroplsty fluor                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72291TCPerq verte/sacroplsty fluor                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7229126Perq verte/sacroplsty fluor                       A   1.31   0.61     0.60     0.61     0.60     0.22   2.14   2.13   2.14   2.13  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72292  Perq verte/sacroplsty ct                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72292TCPerq verte/sacroplsty ct                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7229226Perq verte/sacroplsty ct                          A   1.38   0.62     0.58     0.62     0.58     0.20   2.20   2.16   2.20   2.16  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
72295  X-ray of lower spine disk                         A   0.83   2.97     2.12     2.97NA   2.12 NA  0.05   3.85   3.00   3.85   3.00  1XXX.00.00.0000000             25.5217 090 99     65.64  65.64   0.29
72295TCX-ray of lower spine disk                         A   0.00   2.60     1.70     2.60NA   1.70 NA  0.01   2.61   1.71   2.61   1.71  1XXX.00.00.0000000             25.5217 030 99     65.27  65.27   0.25
7229526X-ray of lower spine disk                         A   0.83   0.37     0.42     0.37     0.42     0.04   1.24   1.29   1.24   1.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
73000  X-ray exam of collar bone                         A   0.16   0.67     0.66     0.67NA   0.66 NA  0.02   0.85   0.84   0.85   0.84  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.04
73000TCX-ray exam of collar bone                         A   0.00   0.60     0.58     0.60NA   0.58 NA  0.01   0.61   0.59   0.61   0.59  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7300026X-ray exam of collar bone                         A   0.16   0.07     0.08     0.07     0.08     0.01   0.24   0.25   0.24   0.25  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73010  X-ray exam of shoulder blade                      A   0.17   0.71     0.72     0.71NA   0.72 NA  0.04   0.92   0.93   0.92   0.93  1XXX.00.00.0003000             25.5217 090 99      1.82   1.82   0.06
73010TCX-ray exam of shoulder blade                      A   0.00   0.63     0.63     0.63NA   0.63 NA  0.01   0.64   0.64   0.64   0.64  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7301026X-ray exam of shoulder blade                      A   0.17   0.08     0.09     0.08     0.09     0.03   0.28   0.29   0.28   0.29  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73020  X-ray exam of shoulder                            A   0.15   0.55     0.52     0.55NA   0.52 NA  0.02   0.72   0.69   0.72   0.69  1XXX.00.00.0003000             25.5217 090 99      1.80   1.80   0.05
73020TCX-ray exam of shoulder                            A   0.00   0.48     0.45     0.48NA   0.45 NA  0.01   0.49   0.46   0.49   0.46  1XXX.00.00.0003000             25.5217 010 99      1.73   1.73   0.04
7302026X-ray exam of shoulder                            A   0.15   0.07     0.07     0.07     0.07     0.01   0.23   0.23   0.23   0.23  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73030  X-ray exam of shoulder                            A   0.18   0.70     0.68     0.70NA   0.68 NA  0.04   0.92   0.90   0.92   0.90  1XXX.00.00.0003000             25.5217 090 99      1.83   1.83   0.06
73030TCX-ray exam of shoulder                            A   0.00   0.61     0.59     0.61NA   0.59 NA  0.01   0.62   0.60   0.62   0.60  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7303026X-ray exam of shoulder                            A   0.18   0.09     0.09     0.09     0.09     0.03   0.30   0.30   0.30   0.30  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73040  Contrast x-ray of shoulder                        A   0.54   2.62     2.48     2.62NA   2.48 NA  0.05   3.21   3.07   3.21   3.07  1XXX.00.00.0003000             25.5217 090 99     10.97  10.97   0.09
73040TCContrast x-ray of shoulder                        A   0.00   2.38     2.25     2.38NA   2.25 NA  0.01   2.39   2.26   2.39   2.26  1XXX.00.00.0003000             25.5217 030 99     10.73  10.73   0.05
7304026Contrast x-ray of shoulder                        A   0.54   0.24     0.23     0.24     0.23     0.04   0.82   0.81   0.82   0.81  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73050  X-ray exam of shoulders                           A   0.20   0.91     0.91     0.91NA   0.91 NA  0.04   1.15   1.15   1.15   1.15  1XXX.00.00.0002000             25.5217 090 99      1.84   1.84   0.05
73050TCX-ray exam of shoulders                           A   0.00   0.81     0.81     0.81NA   0.81 NA  0.01   0.82   0.82   0.82   0.82  1XXX.00.00.0002000             25.5217 010 99      1.74   1.74   0.02
7305026X-ray exam of shoulders                           A   0.20   0.10     0.10     0.10     0.10     0.03   0.33   0.33   0.33   0.33  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
73060  X-ray exam of humerus                             A   0.17   0.69     0.65     0.69NA   0.65 NA  0.02   0.88   0.84   0.88   0.84  1XXX.00.00.0003000             25.5217 090 99      1.82   1.82   0.04
73060TCX-ray exam of humerus                             A   0.00   0.61     0.57     0.61NA   0.57 NA  0.01   0.62   0.58   0.62   0.58  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7306026X-ray exam of humerus                             A   0.17   0.08     0.08     0.08     0.08     0.01   0.26   0.26   0.26   0.26  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73070  X-ray exam of elbow                               A   0.15   0.67     0.65     0.67NA   0.65 NA  0.02   0.84   0.82   0.84   0.82  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.04
73070TCX-ray exam of elbow                               A   0.00   0.60     0.58     0.60NA   0.58 NA  0.01   0.61   0.59   0.61   0.59  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7307026X-ray exam of elbow                               A   0.15   0.07     0.07     0.07     0.07     0.01   0.23   0.23   0.23   0.23  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73080  X-ray exam of elbow                               A   0.17   0.82     0.77     0.82NA   0.77 NA  0.02   1.01   0.96   1.01   0.96  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.03
73080TCX-ray exam of elbow                               A   0.00   0.75     0.70     0.75NA   0.70 NA  0.01   0.76   0.71   0.76   0.71  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.02
7308026X-ray exam of elbow                               A   0.17   0.07     0.07     0.07     0.07     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73085  Contrast x-ray of elbow                           A   0.54   2.32     2.22     2.32NA   2.22 NA  0.04   2.90   2.80   2.90   2.80  1XXX.00.00.0003000             25.5217 090 99     10.97  10.97   0.08
73085TCContrast x-ray of elbow                           A   0.00   2.08     1.97     2.08NA   1.97 NA  0.01   2.09   1.98   2.09   1.98  1XXX.00.00.0003000             25.5217 030 99     10.73  10.73   0.05
7308526Contrast x-ray of elbow                           A   0.54   0.24     0.25     0.24     0.25     0.03   0.81   0.82   0.81   0.82  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73090  X-ray exam of forearm                             A   0.16   0.65     0.62     0.65NA   0.62 NA  0.02   0.83   0.80   0.83   0.80  1XXX.00.00.0003000             25.5217 090 99      1.80   1.80   0.04
73090TCX-ray exam of forearm                             A   0.00   0.58     0.55     0.58NA   0.55 NA  0.01   0.59   0.56   0.59   0.56  1XXX.00.00.0003000             25.5217 010 99      1.73   1.73   0.03
7309026X-ray exam of forearm                             A   0.16   0.07     0.07     0.07     0.07     0.01   0.24   0.24   0.24   0.24  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73092  X-ray exam of arm infant                          A   0.16   0.73     0.76     0.73NA   0.76 NA  0.02   0.91   0.94   0.91   0.94  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.04
73092TCX-ray exam of arm infant                          A   0.00   0.66     0.69     0.66NA   0.69 NA  0.01   0.67   0.70   0.67   0.70  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7309226X-ray exam of arm infant                          A   0.16   0.07     0.07     0.07     0.07     0.01   0.24   0.24   0.24   0.24  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73100  X-ray exam of wrist                               A   0.16   0.73     0.73     0.73NA   0.73 NA  0.04   0.93   0.93   0.93   0.93  1XXX.00.00.0003000             25.5217 090 99      1.82   1.82   0.06
73100TCX-ray exam of wrist                               A   0.00   0.65     0.65     0.65NA   0.65 NA  0.01   0.66   0.66   0.66   0.66  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7310026X-ray exam of wrist                               A   0.16   0.08     0.08     0.08     0.08     0.03   0.27   0.27   0.27   0.27  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73110  X-ray exam of wrist                               A   0.17   0.89     0.90     0.89NA   0.90 NA  0.02   1.08   1.09   1.08   1.09  1XXX.00.00.0003000             25.5217 090 99      1.82   1.82   0.03
73110TCX-ray exam of wrist                               A   0.00   0.81     0.82     0.81NA   0.82 NA  0.01   0.82   0.83   0.82   0.83  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.02
7311026X-ray exam of wrist                               A   0.17   0.08     0.08     0.08     0.08     0.01   0.26   0.26   0.26   0.26  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73115  Contrast x-ray of wrist                           A   0.54   2.65     2.67     2.65NA   2.67 NA  0.05   3.24   3.26   3.24   3.26  1XXX.00.00.0003000             25.5217 090 99     10.98  10.98   0.08
73115TCContrast x-ray of wrist                           A   0.00   2.40     2.42     2.40NA   2.42 NA  0.01   2.41   2.43   2.41   2.43  1XXX.00.00.0003000             25.5217 030 99     10.73  10.73   0.04
7311526Contrast x-ray of wrist                           A   0.54   0.25     0.25     0.25     0.25     0.04   0.83   0.83   0.83   0.83  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73120  X-ray exam of hand                                A   0.16   0.65     0.62     0.65NA   0.62 NA  0.02   0.83   0.80   0.83   0.80  1XXX.00.00.0003000             25.5217 090 99      1.80   1.80   0.04
73120TCX-ray exam of hand                                A   0.00   0.58     0.55     0.58NA   0.55 NA  0.01   0.59   0.56   0.59   0.56  1XXX.00.00.0003000             25.5217 010 99      1.73   1.73   0.03
7312026X-ray exam of hand                                A   0.16   0.07     0.07     0.07     0.07     0.01   0.24   0.24   0.24   0.24  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73130  X-ray exam of hand                                A   0.17   0.76     0.75     0.76NA   0.75 NA  0.02   0.95   0.94   0.95   0.94  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.04
73130TCX-ray exam of hand                                A   0.00   0.69     0.67     0.69NA   0.67 NA  0.01   0.70   0.68   0.70   0.68  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7313026X-ray exam of hand                                A   0.17   0.07     0.08     0.07     0.08     0.01   0.25   0.26   0.25   0.26  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73140  X-ray exam of finger(s)                           A   0.13   0.79     0.81     0.79NA   0.81 NA  0.02   0.94   0.96   0.94   0.96  1XXX.00.00.0003000             25.5217 090 99      1.80   1.80   0.03
73140TCX-ray exam of finger(s)                           A   0.00   0.73     0.75     0.73NA   0.75 NA  0.01   0.74   0.76   0.74   0.76  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.02
7314026X-ray exam of finger(s)                           A   0.13   0.06     0.06     0.06     0.06     0.01   0.20   0.20   0.20   0.20  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73200  Ct upper extremity w/o dye                        A   1.00   6.19     4.95     6.19NA   4.95 NA  0.07   7.26   6.02   7.26   6.02  1XXX.00.00.0043000             25.5217 090 88      8.01   8.01   0.07
73200TCCt upper extremity w/o dye                        A   0.00   5.76     4.57     5.76NA   4.57 NA  0.01   5.77   4.58   5.77   4.58  1XXX.00.00.0043000             25.5217 010 88      7.58   7.58   0.01
7320026Ct upper extremity w/o dye                        A   1.00   0.43     0.38     0.43     0.38     0.06   1.49   1.44   1.49   1.44  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73201  Ct upper extremity w/dye                          A   1.16   7.64     6.18     7.64NA   6.18 NA  0.08   8.88   7.42   8.88   7.42  1XXX.00.00.0043000             25.5217 090 88     12.21  12.21   0.09
73201TCCt upper extremity w/dye                          A   0.00   7.16     5.74     7.16NA   5.74 NA  0.01   7.17   5.75   7.17   5.75  1XXX.00.00.0043000             25.5217 020 88     11.73  11.73   0.02
7320126Ct upper extremity w/dye                          A   1.16   0.48     0.44     0.48     0.44     0.07   1.71   1.67   1.71   1.67  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73202  Ct uppr extremity w/o&w/dye                       A   1.22  10.06     8.13    10.06NA   8.13 NA  0.08  11.36   9.43  11.36   9.43  1XXX.00.00.0043000             25.5217 090 88     13.58  13.58   0.08
73202TCCt uppr extremity w/o&w/dye                       A   0.00   9.56     7.67     9.56NA   7.67 NA  0.01   9.57   7.68   9.57   7.68  1XXX.00.00.0043000             25.5217 020 88     13.08  13.08   0.01
7320226Ct uppr extremity w/o&w/dye                       A   1.22   0.50     0.46     0.50     0.46     0.07   1.79   1.75   1.79   1.75  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73206  Ct angio upr extrm w/o&w/dye                      A   1.81  10.99     8.51    10.99NA   8.51 NA  0.09  12.89  10.41  12.89  10.41  1XXX.00.00.0040000             25.5217 090 88     14.02  14.02   0.09
73206TCCt angio upr extrm w/o&w/dye                      A   0.00  10.22     7.84    10.22NA   7.84 NA  0.01  10.23   7.85  10.23   7.85  1XXX.00.00.0040000             25.5217 020 88     13.25  13.25   0.01
7320626Ct angio upr extrm w/o&w/dye                      A   1.81   0.77     0.67     0.77     0.67     0.08   2.66   2.56   2.66   2.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
73218  Mri upper extremity w/o dye                       A   1.35  13.91    10.97    13.91NA  10.97 NA  0.08  15.34  12.40  15.34  12.40  1XXX.00.00.0043000             25.5217 090 88     13.99  13.99   0.08
73218TCMri upper extremity w/o dye                       A   0.00  13.35    10.44    13.35NA  10.44 NA  0.01  13.36  10.45  13.36  10.45  1XXX.00.00.0043000             25.5217 010 88     13.43  13.43   0.01
7321826Mri upper extremity w/o dye                       A   1.35   0.56     0.53     0.56     0.53     0.07   1.98   1.95   1.98   1.95  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73219  Mri upper extremity w/dye                         A   1.62  14.88    11.48    14.88NA  11.48 NA  0.11  16.61  13.21  16.61  13.21  1XXX.00.00.0043000             25.5217 090 88     17.78  17.78   0.11
73219TCMri upper extremity w/dye                         A   0.00  14.21    10.86    14.21NA  10.86 NA  0.01  14.22  10.87  14.22  10.87  1XXX.00.00.0043000             25.5217 020 88     17.11  17.11   0.01
7321926Mri upper extremity w/dye                         A   1.62   0.67     0.62     0.67     0.62     0.10   2.39   2.34   2.39   2.34  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73220  Mri uppr extremity w/o&w/dye                      A   2.15  19.66    14.27    19.66NA  14.27 NA  0.13  21.94  16.55  21.94  16.55  1XXX.00.00.0043000             25.5217 090 88     21.79  21.79   0.13
73220TCMri uppr extremity w/o&w/dye                      A   0.00  18.77    13.46    18.77NA  13.46 NA  0.01  18.78  13.47  18.78  13.47  1XXX.00.00.0043000             25.5217 020 88     20.90  20.90   0.01
7322026Mri uppr extremity w/o&w/dye                      A   2.15   0.89     0.81     0.89     0.81     0.12   3.16   3.08   3.16   3.08  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73221  Mri joint upr extrem w/o dye                      A   1.35  13.00    10.17    13.00NA  10.17 NA  0.11  14.46  11.63  14.46  11.63  1XXX.00.00.0043000             25.5217 090 88     14.00  14.00   0.11
73221TCMri joint upr extrem w/o dye                      A   0.00  12.43     9.63    12.43NA   9.63 NA  0.01  12.44   9.64  12.44   9.64  1XXX.00.00.0043000             25.5217 010 88     13.43  13.43   0.01
7322126Mri joint upr extrem w/o dye                      A   1.35   0.57     0.54     0.57     0.54     0.10   2.02   1.99   2.02   1.99  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73222  Mri joint upr extrem w/dye                        A   1.62  14.03    10.81    14.03NA  10.81 NA  0.11  15.76  12.54  15.76  12.54  1XXX.00.00.0043000             25.5217 090 88     17.78  17.78   0.11
73222TCMri joint upr extrem w/dye                        A   0.00  13.36    10.19    13.36NA  10.19 NA  0.01  13.37  10.20  13.37  10.20  1XXX.00.00.0043000             25.5217 020 88     17.11  17.11   0.01
7322226Mri joint upr extrem w/dye                        A   1.62   0.67     0.62     0.67     0.62     0.10   2.39   2.34   2.39   2.34  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73223  Mri joint upr extr w/o&w/dye                      A   2.15  18.55    13.30    18.55NA  13.30 NA  0.13  20.83  15.58  20.83  15.58  1XXX.00.00.0043000             25.5217 090 88     21.79  21.79   0.13
73223TCMri joint upr extr w/o&w/dye                      A   0.00  17.66    12.48    17.66NA  12.48 NA  0.01  17.67  12.49  17.67  12.49  1XXX.00.00.0043000             25.5217 020 88     20.90  20.90   0.01
7322326Mri joint upr extr w/o&w/dye                      A   2.15   0.89     0.82     0.89     0.82     0.12   3.16   3.09   3.16   3.09  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73225  Mr angio upr extr w/o&w/dye                       R   1.73  16.08    13.65    16.08NA  13.65 NA  0.08  17.89  15.46  17.89  15.46  1XXX.00.00.0040000             25.5217 090 88     21.64  21.64   0.08
73225TCMr angio upr extr w/o&w/dye                       R   0.00  15.33    12.89    15.33NA  12.89 NA  0.01  15.34  12.90  15.34  12.90  1XXX.00.00.0040900             25.5217 020 88     20.89  20.89   0.01
7322526Mr angio upr extr w/o&w/dye                       R   1.73   0.75     0.76     0.75     0.76     0.07   2.55   2.56   2.55   2.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
73500  X-ray exam of hip                                 A   0.17   0.59     0.58     0.59NA   0.58 NA  0.04   0.80   0.79   0.80   0.79  1XXX.00.00.0000000             25.5217 090 99      1.81   1.81   0.06
73500TCX-ray exam of hip                                 A   0.00   0.51     0.50     0.51NA   0.50 NA  0.01   0.52   0.51   0.52   0.51  1XXX.00.00.0000000             25.5217 010 99      1.73   1.73   0.03
7350026X-ray exam of hip                                 A   0.17   0.08     0.08     0.08     0.08     0.03   0.28   0.28   0.28   0.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
73510  X-ray exam of hip                                 A   0.21   0.90     0.89     0.90NA   0.89 NA  0.04   1.15   1.14   1.15   1.14  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.05
73510TCX-ray exam of hip                                 A   0.00   0.80     0.79     0.80NA   0.79 NA  0.01   0.81   0.80   0.81   0.80  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7351026X-ray exam of hip                                 A   0.21   0.10     0.10     0.10     0.10     0.03   0.34   0.34   0.34   0.34  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
73520  X-ray exam of hips                                A   0.26   0.92     0.90     0.92NA   0.90 NA  0.04   1.22   1.20   1.22   1.20  1XXX.00.00.0002000             25.5217 090 99      1.85   1.85   0.05
73520TCX-ray exam of hips                                A   0.00   0.81     0.78     0.81NA   0.78 NA  0.01   0.82   0.79   0.82   0.79  1XXX.00.00.0002000             25.5217 010 99      1.74   1.74   0.02
7352026X-ray exam of hips                                A   0.26   0.11     0.12     0.11     0.12     0.03   0.40   0.41   0.40   0.41  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
73525  Contrast x-ray of hip                             A   0.54   2.40     2.38     2.40NA   2.38 NA  0.05   2.99   2.97   2.99   2.97  1XXX.00.00.0003000             25.5217 090 99     10.99  10.99   0.09
73525TCContrast x-ray of hip                             A   0.00   2.14     2.11     2.14NA   2.11 NA  0.01   2.15   2.12   2.15   2.12  1XXX.00.00.0003000             25.5217 030 99     10.73  10.73   0.05
7352526Contrast x-ray of hip                             A   0.54   0.26     0.27     0.26     0.27     0.04   0.84   0.85   0.84   0.85  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73530  X-ray exam of hip                                 C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73530TCX-ray exam of hip                                 C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0003000             25.5217 030 99      0.00   0.00   0.00
7353026X-ray exam of hip                                 A   0.29   0.12     0.11     0.12     0.11     0.03   0.44   0.43   0.44   0.43  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73540  X-ray exam of pelvis & hips                       A   0.20   0.98     1.04     0.98NA   1.04 NA  0.04   1.22   1.28   1.22   1.28  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.05
73540TCX-ray exam of pelvis & hips                       A   0.00   0.89     0.94     0.89NA   0.94 NA  0.01   0.90   0.95   0.90   0.95  1XXX.00.00.0000000             25.5217 010 99      1.75   1.75   0.02
7354026X-ray exam of pelvis & hips                       A   0.20   0.09     0.10     0.09     0.10     0.03   0.32   0.33   0.32   0.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
73542  X-ray exam sacroiliac joint                       A   0.59   1.82     1.85     1.82NA   1.85 NA  0.04   2.45   2.48   2.45   2.48  1XXX.00.00.0099999             25.5217 090 99     10.96  10.96   0.10
73542TCX-ray exam sacroiliac joint                       A   0.00   1.57     1.56     1.57NA   1.56 NA  0.01   1.58   1.57   1.58   1.57  1XXX.00.00.0099999             25.5217 030 99     10.71  10.71   0.07
7354226X-ray exam sacroiliac joint                       A   0.59   0.25     0.29     0.25     0.29     0.03   0.87   0.91   0.87   0.91  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
73550  X-ray exam of thigh                               A   0.17   0.66     0.62     0.66NA   0.62 NA  0.04   0.87   0.83   0.87   0.83  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.06
73550TCX-ray exam of thigh                               A   0.00   0.58     0.54     0.58NA   0.54 NA  0.01   0.59   0.55   0.59   0.55  1XXX.00.00.0003000             25.5217 010 99      1.73   1.73   0.03
7355026X-ray exam of thigh                               A   0.17   0.08     0.08     0.08     0.08     0.03   0.28   0.28   0.28   0.28  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73560  X-ray exam of knee 1 or 2                         A   0.17   0.70     0.69     0.70NA   0.69 NA  0.04   0.91   0.90   0.91   0.90  1XXX.00.00.0003000             25.5217 090 99      1.82   1.82   0.06
73560TCX-ray exam of knee 1 or 2                         A   0.00   0.62     0.61     0.62NA   0.61 NA  0.01   0.63   0.62   0.63   0.62  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7356026X-ray exam of knee 1 or 2                         A   0.17   0.08     0.08     0.08     0.08     0.03   0.28   0.28   0.28   0.28  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73562  X-ray exam of knee 3                              A   0.18   0.87     0.87     0.87NA   0.87 NA  0.04   1.09   1.09   1.09   1.09  1XXX.00.00.0003000             25.5217 090 99      1.83   1.83   0.05
73562TCX-ray exam of knee 3                              A   0.00   0.78     0.78     0.78NA   0.78 NA  0.01   0.79   0.79   0.79   0.79  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.02
7356226X-ray exam of knee 3                              A   0.18   0.09     0.09     0.09     0.09     0.03   0.30   0.30   0.30   0.30  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73564  X-ray exam knee 4 or more                         A   0.22   1.00     1.00     1.00NA   1.00 NA  0.04   1.26   1.26   1.26   1.26  1XXX.00.00.0003000             25.5217 090 99      1.85   1.85   0.05
73564TCX-ray exam knee 4 or more                         A   0.00   0.90     0.90     0.90NA   0.90 NA  0.01   0.91   0.91   0.91   0.91  1XXX.00.00.0003000             25.5217 010 99      1.75   1.75   0.02
7356426X-ray exam knee 4 or more                         A   0.22   0.10     0.10     0.10     0.10     0.03   0.35   0.35   0.35   0.35  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73565  X-ray exam of knees                               A   0.17   0.80     0.83     0.80NA   0.83 NA  0.04   1.01   1.04   1.01   1.04  1XXX.00.00.0002000             25.5217 090 99      1.83   1.83   0.05
73565TCX-ray exam of knees                               A   0.00   0.71     0.74     0.71NA   0.74 NA  0.01   0.72   0.75   0.72   0.75  1XXX.00.00.0002000             25.5217 010 99      1.74   1.74   0.02
7356526X-ray exam of knees                               A   0.17   0.09     0.09     0.09     0.09     0.03   0.29   0.29   0.29   0.29  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
73580  Contrast x-ray of knee joint                      A   0.54   3.31     3.44     3.31NA   3.44 NA  0.06   3.91   4.04   3.91   4.04  1XXX.00.00.0003000             25.5217 090 99     11.01  11.01   0.09
73580TCContrast x-ray of knee joint                      A   0.00   3.04     3.14     3.04NA   3.14 NA  0.01   3.05   3.15   3.05   3.15  1XXX.00.00.0003000             25.5217 030 99     10.74  10.74   0.04
7358026Contrast x-ray of knee joint                      A   0.54   0.27     0.30     0.27     0.30     0.05   0.86   0.89   0.86   0.89  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73590  X-ray exam of lower leg                           A   0.17   0.63     0.60     0.63NA   0.60 NA  0.02   0.82   0.79   0.82   0.79  1XXX.00.00.0003000             25.5217 090 99      1.80   1.80   0.04
73590TCX-ray exam of lower leg                           A   0.00   0.56     0.53     0.56NA   0.53 NA  0.01   0.57   0.54   0.57   0.54  1XXX.00.00.0003000             25.5217 010 99      1.73   1.73   0.03
7359026X-ray exam of lower leg                           A   0.17   0.07     0.07     0.07     0.07     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73592  X-ray exam of leg infant                          A   0.16   0.75     0.79     0.75NA   0.79 NA  0.02   0.93   0.97   0.93   0.97  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.04
73592TCX-ray exam of leg infant                          A   0.00   0.68     0.71     0.68NA   0.71 NA  0.01   0.69   0.72   0.69   0.72  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7359226X-ray exam of leg infant                          A   0.16   0.07     0.08     0.07     0.08     0.01   0.24   0.25   0.24   0.25  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73600  X-ray exam of ankle                               A   0.16   0.66     0.66     0.66NA   0.66 NA  0.02   0.84   0.84   0.84   0.84  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.04
73600TCX-ray exam of ankle                               A   0.00   0.59     0.59     0.59NA   0.59 NA  0.01   0.60   0.60   0.60   0.60  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7360026X-ray exam of ankle                               A   0.16   0.07     0.07     0.07     0.07     0.01   0.24   0.24   0.24   0.24  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73610  X-ray exam of ankle                               A   0.17   0.78     0.78     0.78NA   0.78 NA  0.02   0.97   0.97   0.97   0.97  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.03
73610TCX-ray exam of ankle                               A   0.00   0.71     0.70     0.71NA   0.70 NA  0.01   0.72   0.71   0.72   0.71  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.02
7361026X-ray exam of ankle                               A   0.17   0.07     0.08     0.07     0.08     0.01   0.25   0.26   0.25   0.26  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73615  Contrast x-ray of ankle                           A   0.54   2.50     2.52     2.50NA   2.52 NA  0.05   3.09   3.11   3.09   3.11  1XXX.00.00.0003000             25.5217 090 99     10.98  10.98   0.09
73615TCContrast x-ray of ankle                           A   0.00   2.25     2.25     2.25NA   2.25 NA  0.01   2.26   2.26   2.26   2.26  1XXX.00.00.0003000             25.5217 030 99     10.73  10.73   0.05
7361526Contrast x-ray of ankle                           A   0.54   0.25     0.27     0.25     0.27     0.04   0.83   0.85   0.83   0.85  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73620  X-ray exam of foot                                A   0.16   0.64     0.64     0.64NA   0.64 NA  0.02   0.82   0.82   0.82   0.82  1XXX.00.00.0003000             25.5217 090 99      1.79   1.79   0.04
73620TCX-ray exam of foot                                A   0.00   0.58     0.58     0.58NA   0.58 NA  0.01   0.59   0.59   0.59   0.59  1XXX.00.00.0003000             25.5217 010 99      1.73   1.73   0.03
7362026X-ray exam of foot                                A   0.16   0.06     0.06     0.06     0.06     0.01   0.23   0.23   0.23   0.23  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73630  X-ray exam of foot                                A   0.17   0.75     0.73     0.75NA   0.73 NA  0.02   0.94   0.92   0.94   0.92  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.04
73630TCX-ray exam of foot                                A   0.00   0.68     0.66     0.68NA   0.66 NA  0.01   0.69   0.67   0.69   0.67  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7363026X-ray exam of foot                                A   0.17   0.07     0.07     0.07     0.07     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73650  X-ray exam of heel                                A   0.16   0.66     0.65     0.66NA   0.65 NA  0.02   0.84   0.83   0.84   0.83  1XXX.00.00.0003000             25.5217 090 99      1.81   1.81   0.04
73650TCX-ray exam of heel                                A   0.00   0.59     0.58     0.59NA   0.58 NA  0.01   0.60   0.59   0.60   0.59  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7365026X-ray exam of heel                                A   0.16   0.07     0.07     0.07     0.07     0.01   0.24   0.24   0.24   0.24  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73660  X-ray exam of toe(s)                              A   0.13   0.72     0.74     0.72NA   0.74 NA  0.02   0.87   0.89   0.87   0.89  1XXX.00.00.0003000             25.5217 090 99      1.79   1.79   0.04
73660TCX-ray exam of toe(s)                              A   0.00   0.67     0.68     0.67NA   0.68 NA  0.01   0.68   0.69   0.68   0.69  1XXX.00.00.0003000             25.5217 010 99      1.74   1.74   0.03
7366026X-ray exam of toe(s)                              A   0.13   0.05     0.06     0.05     0.06     0.01   0.19   0.20   0.19   0.20  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73700  Ct lower extremity w/o dye                        A   1.00   6.21     4.96     6.21NA   4.96 NA  0.07   7.28   6.03   7.28   6.03  1XXX.00.00.0043000             25.5217 090 88      8.01   8.01   0.07
73700TCCt lower extremity w/o dye                        A   0.00   5.78     4.59     5.78NA   4.59 NA  0.01   5.79   4.60   5.79   4.60  1XXX.00.00.0043000             25.5217 010 88      7.58   7.58   0.01
7370026Ct lower extremity w/o dye                        A   1.00   0.43     0.37     0.43     0.37     0.06   1.49   1.43   1.49   1.43  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73701  Ct lower extremity w/dye                          A   1.16   7.73     6.25     7.73NA   6.25 NA  0.08   8.97   7.49   8.97   7.49  1XXX.00.00.0043000             25.5217 090 88     12.22  12.22   0.09
73701TCCt lower extremity w/dye                          A   0.00   7.24     5.82     7.24NA   5.82 NA  0.01   7.25   5.83   7.25   5.83  1XXX.00.00.0043000             25.5217 020 88     11.73  11.73   0.02
7370126Ct lower extremity w/dye                          A   1.16   0.49     0.43     0.49     0.43     0.07   1.72   1.66   1.72   1.66  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73702  Ct lwr extremity w/o&w/dye                        A   1.22  10.12     8.19    10.12NA   8.19 NA  0.08  11.42   9.49  11.42   9.49  1XXX.00.00.0043000             25.5217 090 88     13.59  13.59   0.08
73702TCCt lwr extremity w/o&w/dye                        A   0.00   9.61     7.73     9.61NA   7.73 NA  0.01   9.62   7.74   9.62   7.74  1XXX.00.00.0043000             25.5217 020 88     13.08  13.08   0.01
7370226Ct lwr extremity w/o&w/dye                        A   1.22   0.51     0.46     0.51     0.46     0.07   1.80   1.75   1.80   1.75  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73706  Ct angio lwr extr w/o&w/dye                       A   1.90  12.15     9.57    12.15NA   9.57 NA  0.12  14.17  11.59  14.17  11.59  1XXX.00.00.0043000             25.5217 090 88     14.06  14.06   0.12
73706TCCt angio lwr extr w/o&w/dye                       A   0.00  11.34     8.86    11.34NA   8.86 NA  0.01  11.35   8.87  11.35   8.87  1XXX.00.00.0043000             25.5217 020 88     13.25  13.25   0.01
7370626Ct angio lwr extr w/o&w/dye                       A   1.90   0.81     0.71     0.81     0.71     0.11   2.82   2.72   2.82   2.72  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73718  Mri lower extremity w/o dye                       A   1.35  13.60    10.68    13.60NA  10.68 NA  0.09  15.04  12.12  15.04  12.12  1XXX.00.00.0043000             25.5217 090 88     13.99  13.99   0.09
73718TCMri lower extremity w/o dye                       A   0.00  13.04    10.17    13.04NA  10.17 NA  0.01  13.05  10.18  13.05  10.18  1XXX.00.00.0043000             25.5217 010 88     13.43  13.43   0.01
7371826Mri lower extremity w/o dye                       A   1.35   0.56     0.51     0.56     0.51     0.08   1.99   1.94   1.99   1.94  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73719  Mri lower extremity w/dye                         A   1.62  14.83    11.61    14.83NA  11.61 NA  0.11  16.56  13.34  16.56  13.34  1XXX.00.00.0043000             25.5217 090 88     17.77  17.77   0.11
73719TCMri lower extremity w/dye                         A   0.00  14.17    11.00    14.17NA  11.00 NA  0.01  14.18  11.01  14.18  11.01  1XXX.00.00.0043000             25.5217 020 88     17.11  17.11   0.01
7371926Mri lower extremity w/dye                         A   1.62   0.66     0.61     0.66     0.61     0.10   2.38   2.33   2.38   2.33  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73720  Mri lwr extremity w/o&w/dye                       A   2.15  19.69    14.32    19.69NA  14.32 NA  0.13  21.97  16.60  21.97  16.60  1XXX.00.00.0043000             25.5217 090 88     21.79  21.79   0.13
73720TCMri lwr extremity w/o&w/dye                       A   0.00  18.80    13.52    18.80NA  13.52 NA  0.01  18.81  13.53  18.81  13.53  1XXX.00.00.0043000             25.5217 020 88     20.90  20.90   0.01
7372026Mri lwr extremity w/o&w/dye                       A   2.15   0.89     0.80     0.89     0.80     0.12   3.16   3.07   3.16   3.07  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73721  Mri jnt of lwr extre w/o dye                      A   1.35  13.29    10.42    13.29NA  10.42 NA  0.11  14.75  11.88  14.75  11.88  1XXX.00.00.0043000             25.5217 090 88     14.00  14.00   0.11
73721TCMri jnt of lwr extre w/o dye                      A   0.00  12.72     9.89    12.72NA   9.89 NA  0.01  12.73   9.90  12.73   9.90  1XXX.00.00.0043000             25.5217 010 88     13.43  13.43   0.01
7372126Mri jnt of lwr extre w/o dye                      A   1.35   0.57     0.53     0.57     0.53     0.10   2.02   1.98   2.02   1.98  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73722  Mri joint of lwr extr w/dye                       A   1.62  14.28    11.14    14.28NA  11.14 NA  0.12  16.02  12.88  16.02  12.88  1XXX.00.00.0043000             25.5217 090 88     17.79  17.79   0.12
73722TCMri joint of lwr extr w/dye                       A   0.00  13.60    10.51    13.60NA  10.51 NA  0.01  13.61  10.52  13.61  10.52  1XXX.00.00.0043000             25.5217 020 88     17.11  17.11   0.01
7372226Mri joint of lwr extr w/dye                       A   1.62   0.68     0.63     0.68     0.63     0.11   2.41   2.36   2.41   2.36  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73723  Mri joint lwr extr w/o&w/dye                      A   2.15  18.52    13.29    18.52NA  13.29 NA  0.13  20.80  15.57  20.80  15.57  1XXX.00.00.0043000             25.5217 090 88     21.79  21.79   0.13
73723TCMri joint lwr extr w/o&w/dye                      A   0.00  17.63    12.48    17.63NA  12.48 NA  0.01  17.64  12.49  17.64  12.49  1XXX.00.00.0043000             25.5217 020 88     20.90  20.90   0.01
7372326Mri joint lwr extr w/o&w/dye                      A   2.15   0.89     0.81     0.89     0.81     0.12   3.16   3.08   3.16   3.08  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
73725  Mr ang lwr ext w or w/o dye                       R   1.82  14.49    11.61    14.49NA  11.61 NA  0.11  16.42  13.54  16.42  13.54  1XXX.00.00.0043000             25.5217 090 88     21.64  21.64   0.12
73725TCMr ang lwr ext w or w/o dye                       R   0.00  13.74    10.94    13.74NA  10.94 NA  0.01  13.75  10.95  13.75  10.95  1XXX.00.00.0043000             25.5217 020 88     20.89  20.89   0.02
7372526Mr ang lwr ext w or w/o dye                       R   1.82   0.75     0.67     0.75     0.67     0.10   2.67   2.59   2.67   2.59  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
74000  X-ray exam of abdomen                             A   0.18   0.54     0.49     0.54NA   0.49 NA  0.02   0.74   0.69   0.74   0.69  1XXX.00.00.0000000             25.5217 090 99      1.80   1.80   0.05
74000TCX-ray exam of abdomen                             A   0.00   0.47     0.42     0.47NA   0.42 NA  0.01   0.48   0.43   0.48   0.43  1XXX.00.00.0000000             25.5217 010 99      1.73   1.73   0.04
7400026X-ray exam of abdomen                             A   0.18   0.07     0.07     0.07     0.07     0.01   0.26   0.26   0.26   0.26  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74010  X-ray exam of abdomen                             A   0.23   0.89     0.85     0.89NA   0.85 NA  0.02   1.14   1.10   1.14   1.10  1XXX.00.00.0000000             25.5217 090 99      1.84   1.84   0.03
74010TCX-ray exam of abdomen                             A   0.00   0.79     0.76     0.79NA   0.76 NA  0.01   0.80   0.77   0.80   0.77  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7401026X-ray exam of abdomen                             A   0.23   0.10     0.09     0.10     0.09     0.01   0.34   0.33   0.34   0.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74020  X-ray exam of abdomen                             A   0.27   0.90     0.85     0.90NA   0.85 NA  0.02   1.19   1.14   1.19   1.14  1XXX.00.00.0000000             25.5217 090 99      1.85   1.85   0.03
74020TCX-ray exam of abdomen                             A   0.00   0.79     0.75     0.79NA   0.75 NA  0.01   0.80   0.76   0.80   0.76  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7402026X-ray exam of abdomen                             A   0.27   0.11     0.10     0.11     0.10     0.01   0.39   0.38   0.39   0.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74022  X-ray exam series abdomen                         A   0.32   1.09     1.03     1.09NA   1.03 NA  0.02   1.43   1.37   1.43   1.37  1XXX.00.00.0000000             25.5217 090 99      3.07   3.07   0.04
74022TCX-ray exam series abdomen                         A   0.00   0.96     0.91     0.96NA   0.91 NA  0.01   0.97   0.92   0.97   0.92  1XXX.00.00.0000000             25.5217 010 99      2.94   2.94   0.03
7402226X-ray exam series abdomen                         A   0.32   0.13     0.12     0.13     0.12     0.01   0.46   0.45   0.46   0.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74150  Ct abdomen w/o dye                                A   1.19   6.05     4.73     6.05NA   4.73 NA  0.08   7.32   6.00   7.32   6.00  1XXX.00.00.0040000             25.5217 090 88      8.07   8.07   0.08
74150TCCt abdomen w/o dye                                A   0.00   5.56     4.29     5.56NA   4.29 NA  0.01   5.57   4.30   5.57   4.30  1XXX.00.00.0040000             25.5217 010 88      7.58   7.58   0.01
7415026Ct abdomen w/o dye                                A   1.19   0.49     0.44     0.49     0.44     0.07   1.75   1.70   1.75   1.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74160  Ct abdomen w/dye                                  A   1.27   8.55     6.86     8.55NA   6.86 NA  0.08   9.90   8.21   9.90   8.21  1XXX.00.00.0040000             25.5217 090 88     12.26  12.26   0.08
74160TCCt abdomen w/dye                                  A   0.00   8.02     6.38     8.02NA   6.38 NA  0.01   8.03   6.39   8.03   6.39  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.01
7416026Ct abdomen w/dye                                  A   1.27   0.53     0.48     0.53     0.48     0.07   1.87   1.82   1.87   1.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74170  Ct abdomen w/o & w/dye                            A   1.40  11.60     9.39    11.60NA   9.39 NA  0.09  13.09  10.88  13.09  10.88  1XXX.00.00.0040000             25.5217 090 88     13.66  13.66   0.09
74170TCCt abdomen w/o & w/dye                            A   0.00  11.02     8.86    11.02NA   8.86 NA  0.01  11.03   8.87  11.03   8.87  1XXX.00.00.0040000             25.5217 020 88     13.08  13.08   0.01
7417026Ct abdomen w/o & w/dye                            A   1.40   0.58     0.53     0.58     0.53     0.08   2.06   2.01   2.06   2.01  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74175  Ct angio abdom w/o & w/dye                        A   1.90  12.31     9.61    12.31NA   9.61 NA  0.13  14.34  11.64  14.34  11.64  1XXX.00.00.0040000             25.5217 090 88     14.04  14.04   0.13
74175TCCt angio abdom w/o & w/dye                        A   0.00  11.52     8.90    11.52NA   8.90 NA  0.01  11.53   8.91  11.53   8.91  1XXX.00.00.0040000             25.5217 020 88     13.25  13.25   0.01
7417526Ct angio abdom w/o & w/dye                        A   1.90   0.79     0.71     0.79     0.71     0.12   2.81   2.73   2.81   2.73  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74176  Ct abd & pelvis w/o contrast                      A   1.74   4.54     4.54     4.54NA   4.54 NA  0.11   6.39   6.39   6.39   6.39  1XXX.00.00.0040000             25.5217 090 88      8.23   8.23   0.12
74176TCCt abd & pelvis w/o contrast                      A   0.00   3.89     3.89     3.89NA   3.89 NA  0.01   3.90   3.90   3.90   3.90  1XXX.00.00.0040000             25.5217 020 88      7.58   7.58   0.02
7417626Ct abd & pelvis w/o contrast                      A   1.74   0.65     0.65     0.65     0.65     0.10   2.49   2.49   2.49   2.49  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74177  Ct abdomen&pelvis w/contrast                      A   1.82   8.11     8.11     8.11NA   8.11 NA  0.11  10.04  10.04  10.04  10.04  1XXX.00.00.0040000             25.5217 090 88     12.42  12.42   0.12
74177TCCt abdomen&pelvis w/contrast                      A   0.00   7.42     7.42     7.42NA   7.42 NA  0.01   7.43   7.43   7.43   7.43  1XXX.00.00.0040000             25.5217 020 88     11.73  11.73   0.02
7417726Ct abdomen&pelvis w/contrast                      A   1.82   0.69     0.69     0.69     0.69     0.10   2.61   2.61   2.61   2.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74178  Ct abd&pelv 1+ section/regns                      A   2.01  10.57    10.57    10.57NA  10.57 NA  0.14  12.72  12.72  12.72  12.72  1XXX.00.00.0040000             25.5217 090 88     13.83  13.83   0.15
74178TCCt abd&pelv 1+ section/regns                      A   0.00   9.81     9.81     9.81NA   9.81 NA  0.02   9.83   9.83   9.83   9.83  1XXX.00.00.0040000             25.5217 020 88     13.07  13.07   0.03
7417826Ct abd&pelv 1+ section/regns                      A   2.01   0.76     0.76     0.76     0.76     0.12   2.89   2.89   2.89   2.89  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74181  Mri abdomen w/o dye                               A   1.46  12.10     9.33    12.10NA   9.33 NA  0.09  13.65  10.88  13.65  10.88  1XXX.00.00.0040000             25.5217 090 88     14.03  14.03   0.09
74181TCMri abdomen w/o dye                               A   0.00  11.50     8.79    11.50NA   8.79 NA  0.01  11.51   8.80  11.51   8.80  1XXX.00.00.0040000             25.5217 010 88     13.43  13.43   0.01
7418126Mri abdomen w/o dye                               A   1.46   0.60     0.54     0.60     0.54     0.08   2.14   2.08   2.14   2.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74182  Mri abdomen w/dye                                 A   1.73  16.62    13.17    16.62NA  13.17 NA  0.11  18.46  15.01  18.46  15.01  1XXX.00.00.0040000             25.5217 090 88     17.82  17.82   0.11
74182TCMri abdomen w/dye                                 A   0.00  15.91    12.53    15.91NA  12.53 NA  0.01  15.92  12.54  15.92  12.54  1XXX.00.00.0040000             25.5217 020 88     17.11  17.11   0.01
7418226Mri abdomen w/dye                                 A   1.73   0.71     0.64     0.71     0.64     0.10   2.54   2.47   2.54   2.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74183  Mri abdomen w/o & w/dye                           A   2.26  19.66    14.29    19.66NA  14.29 NA  0.13  22.05  16.68  22.05  16.68  1XXX.00.00.0040000             25.5217 090 88     21.83  21.83   0.13
74183TCMri abdomen w/o & w/dye                           A   0.00  18.73    13.45    18.73NA  13.45 NA  0.01  18.74  13.46  18.74  13.46  1XXX.00.00.0040000             25.5217 020 88     20.90  20.90   0.01
7418326Mri abdomen w/o & w/dye                           A   2.26   0.93     0.84     0.93     0.84     0.12   3.31   3.22   3.31   3.22  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74185  Mri angio abdom w orw/o dye                       R   1.80  14.44    11.57    14.44NA  11.57 NA  0.11  16.35  13.48  16.35  13.48  1XXX.00.00.0040000             25.5217 090 88     21.63  21.63   0.12
74185TCMri angio abdom w orw/o dye                       R   0.00  13.70    10.90    13.70NA  10.90 NA  0.01  13.71  10.91  13.71  10.91  1XXX.00.00.0040000             25.5217 020 88     20.89  20.89   0.02
7418526Mri angio abdom w orw/o dye                       R   1.80   0.74     0.67     0.74     0.67     0.10   2.64   2.57   2.64   2.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74190  X-ray exam of peritoneum                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      9.20   9.20   0.05
74190TCX-ray exam of peritoneum                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      9.00   9.00   0.01
7419026X-ray exam of peritoneum                          A   0.48   0.20     0.18     0.20     0.18     0.04   0.72   0.70   0.72   0.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74210  Contrst x-ray exam of throat                      A   0.36   1.94     1.86     1.94NA   1.86 NA  0.02   2.32   2.24   2.32   2.24  1XXX.00.00.0000000             25.5217 090 99      3.53   3.53   0.03
74210TCContrst x-ray exam of throat                      A   0.00   1.79     1.72     1.79NA   1.72 NA  0.01   1.80   1.73   1.80   1.73  1XXX.00.00.0000000             25.5217 030 99      3.38   3.38   0.02
7421026Contrst x-ray exam of throat                      A   0.36   0.15     0.14     0.15     0.14     0.01   0.52   0.51   0.52   0.51  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74220  Contrast x-ray esophagus                          A   0.46   2.18     2.10     2.18NA   2.10 NA  0.04   2.68   2.60   2.68   2.60  1XXX.00.00.0000000             25.5217 090 99      3.57   3.57   0.05
74220TCContrast x-ray esophagus                          A   0.00   1.99     1.93     1.99NA   1.93 NA  0.01   2.00   1.94   2.00   1.94  1XXX.00.00.0000000             25.5217 030 99      3.38   3.38   0.02
7422026Contrast x-ray esophagus                          A   0.46   0.19     0.17     0.19     0.17     0.03   0.68   0.66   0.68   0.66  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74230  Cine/vid x-ray throat/esoph                       A   0.53   2.15     2.05     2.15NA   2.05 NA  0.04   2.72   2.62   2.72   2.62  1XXX.00.00.0000000             25.5217 090 99      3.60   3.60   0.05
74230TCCine/vid x-ray throat/esoph                       A   0.00   1.93     1.85     1.93NA   1.85 NA  0.01   1.94   1.86   1.94   1.86  1XXX.00.00.0000000             25.5217 030 99      3.38   3.38   0.02
7423026Cine/vid x-ray throat/esoph                       A   0.53   0.22     0.20     0.22     0.20     0.03   0.78   0.76   0.78   0.76  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74235  Remove esophagus obstruction                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74235TCRemove esophagus obstruction                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7423526Remove esophagus obstruction                      A   1.19   0.63     0.67     0.63     0.67     0.10   1.92   1.96   1.92   1.96  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74240  X-ray exam upper gi tract                         A   0.69   2.58     2.53     2.58NA   2.53 NA  0.05   3.32   3.27   3.32   3.27  1XXX.00.00.0000000             25.5217 090 99      3.67   3.67   0.05
74240TCX-ray exam upper gi tract                         A   0.00   2.29     2.26     2.29NA   2.26 NA  0.01   2.30   2.27   2.30   2.27  1XXX.00.00.0000000             25.5217 030 99      3.38   3.38   0.01
7424026X-ray exam upper gi tract                         A   0.69   0.29     0.27     0.29     0.27     0.04   1.02   1.00   1.02   1.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74241  X-ray exam upper gi tract                         A   0.69   2.79     2.71     2.79NA   2.71 NA  0.04   3.52   3.44   3.52   3.44  1XXX.00.00.0000000             25.5217 090 99      3.66   3.66   0.04
74241TCX-ray exam upper gi tract                         A   0.00   2.51     2.45     2.51NA   2.45 NA  0.01   2.52   2.46   2.52   2.46  1XXX.00.00.0000000             25.5217 030 99      3.38   3.38   0.01
7424126X-ray exam upper gi tract                         A   0.69   0.28     0.26     0.28     0.26     0.03   1.00   0.98   1.00   0.98  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74245  X-ray exam upper gi tract                         A   0.91   4.29     4.12     4.29NA   4.12 NA  0.06   5.26   5.09   5.26   5.09  1XXX.00.00.0000000             25.5217 090 99      5.93   5.93   0.06
74245TCX-ray exam upper gi tract                         A   0.00   3.91     3.78     3.91NA   3.78 NA  0.01   3.92   3.79   3.92   3.79  1XXX.00.00.0000000             25.5217 030 99      5.55   5.55   0.01
7424526X-ray exam upper gi tract                         A   0.91   0.38     0.34     0.38     0.34     0.05   1.34   1.30   1.34   1.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74246  Contrst x-ray uppr gi tract                       A   0.69   3.03     2.92     3.03NA   2.92 NA  0.05   3.77   3.66   3.77   3.66  1XXX.00.00.0000000             25.5217 090 99      3.68   3.68   0.05
74246TCContrst x-ray uppr gi tract                       A   0.00   2.74     2.66     2.74NA   2.66 NA  0.01   2.75   2.67   2.75   2.67  1XXX.00.00.0000000             25.5217 030 99      3.39   3.39   0.01
7424626Contrst x-ray uppr gi tract                       A   0.69   0.29     0.26     0.29     0.26     0.04   1.02   0.99   1.02   0.99  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74247  Contrst x-ray uppr gi tract                       A   0.69   3.45     3.36     3.45NA   3.36 NA  0.05   4.19   4.10   4.19   4.10  1XXX.00.00.0000000             25.5217 090 99      3.68   3.68   0.05
74247TCContrst x-ray uppr gi tract                       A   0.00   3.16     3.10     3.16NA   3.10 NA  0.01   3.17   3.11   3.17   3.11  1XXX.00.00.0000000             25.5217 030 99      3.39   3.39   0.01
7424726Contrst x-ray uppr gi tract                       A   0.69   0.29     0.26     0.29     0.26     0.04   1.02   0.99   1.02   0.99  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74249  Contrst x-ray uppr gi tract                       A   0.91   4.70     4.54     4.70NA   4.54 NA  0.06   5.67   5.51   5.67   5.51  1XXX.00.00.0000000             25.5217 090 99      5.93   5.93   0.06
74249TCContrst x-ray uppr gi tract                       A   0.00   4.32     4.20     4.32NA   4.20 NA  0.01   4.33   4.21   4.33   4.21  1XXX.00.00.0000000             25.5217 030 99      5.55   5.55   0.01
7424926Contrst x-ray uppr gi tract                       A   0.91   0.38     0.34     0.38     0.34     0.05   1.34   1.30   1.34   1.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74250  X-ray exam of small bowel                         A   0.47   2.65     2.60     2.65NA   2.60 NA  0.04   3.16   3.11   3.16   3.11  1XXX.00.00.0000000             25.5217 090 99      3.57   3.57   0.04
74250TCX-ray exam of small bowel                         A   0.00   2.46     2.42     2.46NA   2.42 NA  0.01   2.47   2.43   2.47   2.43  1XXX.00.00.0000000             25.5217 020 99      3.38   3.38   0.01
7425026X-ray exam of small bowel                         A   0.47   0.19     0.18     0.19     0.18     0.03   0.69   0.68   0.69   0.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74251  X-ray exam of small bowel                         A   0.69  10.12    10.60    10.12NA  10.60 NA  0.05  10.86  11.34  10.86  11.34  1XXX.00.00.0000000             25.5217 090 99      5.85   5.85   0.05
74251TCX-ray exam of small bowel                         A   0.00   9.83    10.34     9.83NA  10.34 NA  0.01   9.84  10.35   9.84  10.35  1XXX.00.00.0000000             25.5217 030 99      5.56   5.56   0.01
7425126X-ray exam of small bowel                         A   0.69   0.29     0.26     0.29     0.26     0.04   1.02   0.99   1.02   0.99  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74260  X-ray exam of small bowel                         A   0.50   8.42     8.75     8.42NA   8.75 NA  0.04   8.96   9.29   8.96   9.29  1XXX.00.00.0000000             25.5217 090 99      3.59   3.59   0.03
74260TCX-ray exam of small bowel                         A   0.00   8.22     8.56     8.22NA   8.56 NA  0.01   8.23   8.57   8.23   8.57  1XXX.00.00.0000000             25.5217 030 99      3.39   3.39   0.00
7426026X-ray exam of small bowel                         A   0.50   0.20     0.19     0.20     0.19     0.03   0.73   0.72   0.73   0.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74261  Ct colonography dx                                A   2.40  12.76    12.76    12.76NA  12.76 NA  0.14  15.30  15.30  15.30  15.30  1XXX.00.00.0040000             25.5217 090 88      8.50   8.50   0.14
74261TCCt colonography dx                                A   0.00  11.85    11.85    11.85NA  11.85 NA  0.01  11.86  11.86  11.86  11.86  1XXX.00.00.0040000             25.5217 020 88      7.59   7.59   0.01
7426126Ct colonography dx                                A   2.40   0.91     0.91     0.91     0.91     0.13   3.44   3.44   3.44   3.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74262  Ct colonography dx w/dye                          A   2.50  14.33    14.33    14.33NA  14.33 NA  0.15  16.98  16.98  16.98  16.98  1XXX.00.00.0040000             25.5217 090 88     12.68  12.68   0.15
74262TCCt colonography dx w/dye                          A   0.00  13.39    13.39    13.39NA  13.39 NA  0.01  13.40  13.40  13.40  13.40  1XXX.00.00.0040000             25.5217 020 88     11.74  11.74   0.01
7426226Ct colonography dx w/dye                          A   2.50   0.94     0.94     0.94     0.94     0.14   3.58   3.58   3.58   3.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74263  Ct colonography screening                         N+  2.28  20.17    20.17    20.17NA  20.17 NA  0.13  22.58  22.58  22.58  22.58  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
74263TCCt colonography screening                         N+  0.00  19.17    19.17    19.17NA  19.17 NA  0.01  19.18  19.18  19.18  19.18  1XXX.00.00.0099999             25.5217 020 99      0.00   0.00   0.00
7426326Ct colonography screening                         N+  2.28   1.00     1.00     1.00     1.00     0.12   3.40   3.40   3.40   3.40  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
74270  Contrast x-ray exam of colon                      A   0.69   3.81     3.74     3.81NA   3.74 NA  0.05   4.55   4.48   4.55   4.48  1XXX.00.00.0000000             25.5217 090 99      3.68   3.68   0.05
74270TCContrast x-ray exam of colon                      A   0.00   3.52     3.48     3.52NA   3.48 NA  0.01   3.53   3.49   3.53   3.49  1XXX.00.00.0000000             25.5217 030 99      3.39   3.39   0.01
7427026Contrast x-ray exam of colon                      A   0.69   0.29     0.26     0.29     0.26     0.04   1.02   0.99   1.02   0.99  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74280  Contrast x-ray exam of colon                      A   0.99   5.25     5.18     5.25NA   5.18 NA  0.06   6.30   6.23   6.30   6.23  1XXX.00.00.0000000             25.5217 090 99      5.96   5.96   0.06
74280TCContrast x-ray exam of colon                      A   0.00   4.84     4.81     4.84NA   4.81 NA  0.01   4.85   4.82   4.85   4.82  1XXX.00.00.0000000             25.5217 030 99      5.55   5.55   0.01
7428026Contrast x-ray exam of colon                      A   0.99   0.41     0.37     0.41     0.37     0.05   1.45   1.41   1.45   1.41  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74283  Contrast x-ray exam of colon                      A   2.02   4.00     3.77     4.00NA   3.77 NA  0.06   6.08   5.85   6.08   5.85  1XXX.00.00.0000000             25.5217 090 99      4.23   4.23   0.06
74283TCContrast x-ray exam of colon                      A   0.00   3.16     2.99     3.16NA   2.99 NA  0.01   3.17   3.00   3.17   3.00  1XXX.00.00.0000000             25.5217 030 99      3.39   3.39   0.01
7428326Contrast x-ray exam of colon                      A   2.02   0.84     0.78     0.84     0.78     0.05   2.91   2.85   2.91   2.85  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74290  Contrast x-ray gallbladder                        A   0.32   1.68     1.66     1.68NA   1.66 NA  0.02   2.02   2.00   2.02   2.00  1XXX.00.00.0000000             25.5217 090 99      3.51   3.51   0.03
74290TCContrast x-ray gallbladder                        A   0.00   1.55     1.54     1.55NA   1.54 NA  0.01   1.56   1.55   1.56   1.55  1XXX.00.00.0000000             25.5217 010 99      3.38   3.38   0.02
7429026Contrast x-ray gallbladder                        A   0.32   0.13     0.12     0.13     0.12     0.01   0.46   0.45   0.46   0.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74291  Contrast x-rays gallbladder                       A   0.20   1.68     1.77     1.68NA   1.77 NA  0.02   1.90   1.99   1.90   1.99  1XXX.00.00.0000000             25.5217 090 99      3.46   3.46   0.03
74291TCContrast x-rays gallbladder                       A   0.00   1.60     1.69     1.60NA   1.69 NA  0.01   1.61   1.70   1.61   1.70  1XXX.00.00.0000000             25.5217 010 99      3.38   3.38   0.02
7429126Contrast x-rays gallbladder                       A   0.20   0.08     0.08     0.08     0.08     0.01   0.29   0.29   0.29   0.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74300  X-ray bile ducts/pancreas                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74300TCX-ray bile ducts/pancreas                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7430026X-ray bile ducts/pancreas                         A   0.36   0.15     0.14     0.15     0.14     0.03   0.54   0.53   0.54   0.53  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74301  X-rays at surgery add-on                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74301TCX-rays at surgery add-on                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7430126X-rays at surgery add-on                          A   0.21   0.09     0.08     0.09     0.08     0.03   0.33   0.32   0.33   0.32  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74305  X-ray bile ducts/pancreas                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      9.17   9.17   0.05
74305TCX-ray bile ducts/pancreas                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      9.00   9.00   0.01
7430526X-ray bile ducts/pancreas                         A   0.42   0.17     0.15     0.17     0.15     0.04   0.63   0.61   0.63   0.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74320  Contrast x-ray of bile ducts                      A   0.54   2.63     2.26     2.63NA   2.26 NA  0.04   3.21   2.84   3.21   2.84  1XXX.00.00.0000000             25.5217 090 99     16.12  16.12   0.10
74320TCContrast x-ray of bile ducts                      A   0.00   2.40     2.06     2.40NA   2.06 NA  0.01   2.41   2.07   2.41   2.07  1XXX.00.00.0000000             25.5217 030 99     15.89  15.89   0.07
7432026Contrast x-ray of bile ducts                      A   0.54   0.23     0.20     0.23     0.20     0.03   0.80   0.77   0.80   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74327  X-ray bile stone removal                          A   0.70   3.26     3.18     3.26NA   3.18 NA  0.13   4.09   4.01   4.09   4.01  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74327TCX-ray bile stone removal                          A   0.00   2.97     2.92     2.97NA   2.92 NA  0.01   2.98   2.93   2.98   2.93  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7432726X-ray bile stone removal                          A   0.70   0.29     0.26     0.29     0.26     0.12   1.11   1.08   1.11   1.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74328  X-ray bile duct endoscopy                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74328TCX-ray bile duct endoscopy                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7432826X-ray bile duct endoscopy                         A   0.70   0.31     0.29     0.31     0.29     0.05   1.06   1.04   1.06   1.04  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74329  X-ray for pancreas endoscopy                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74329TCX-ray for pancreas endoscopy                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7432926X-ray for pancreas endoscopy                      A   0.70   0.31     0.29     0.31     0.29     0.05   1.06   1.04   1.06   1.04  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74330  X-ray bile/panc endoscopy                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74330TCX-ray bile/panc endoscopy                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7433026X-ray bile/panc endoscopy                         A   0.90   0.39     0.36     0.39     0.36     0.07   1.36   1.33   1.36   1.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74340  X-ray guide for GI tube                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74340TCX-ray guide for GI tube                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7434026X-ray guide for GI tube                           A   0.54   0.23     0.21     0.23     0.21     0.04   0.81   0.79   0.81   0.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74355  X-ray guide intestinal tube                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74355TCX-ray guide intestinal tube                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7435526X-ray guide intestinal tube                       A   0.76   0.33     0.31     0.33     0.31     0.07   1.16   1.14   1.16   1.14  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74360  X-ray guide gi dilation                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74360TCX-ray guide gi dilation                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7436026X-ray guide gi dilation                           A   0.54   0.28     0.28     0.28     0.28     0.04   0.86   0.86   0.86   0.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74363  X-ray bile duct dilation                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74363TCX-ray bile duct dilation                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7436326X-ray bile duct dilation                          A   0.88   0.37     0.32     0.37     0.32     0.08   1.33   1.28   1.33   1.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74400  Contrst x-ray urinary tract                       A   0.49   2.79     2.65     2.79NA   2.65 NA  0.04   3.32   3.18   3.32   3.18  1XXX.00.00.0000000             25.5217 090 99      7.07   7.07   0.06
74400TCContrst x-ray urinary tract                       A   0.00   2.59     2.47     2.59NA   2.47 NA  0.01   2.60   2.48   2.60   2.48  1XXX.00.00.0000000             25.5217 020 99      6.87   6.87   0.03
7440026Contrst x-ray urinary tract                       A   0.49   0.20     0.18     0.20     0.18     0.03   0.72   0.70   0.72   0.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74410  Contrst x-ray urinary tract                       A   0.49   2.89     2.66     2.89NA   2.66 NA  0.04   3.42   3.19   3.42   3.19  1XXX.00.00.0000000             25.5217 090 99      7.09   7.09   0.06
74410TCContrst x-ray urinary tract                       A   0.00   2.68     2.47     2.68NA   2.47 NA  0.01   2.69   2.48   2.69   2.48  1XXX.00.00.0000000             25.5217 020 99      6.88   6.88   0.03
7441026Contrst x-ray urinary tract                       A   0.49   0.21     0.19     0.21     0.19     0.03   0.73   0.71   0.73   0.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74415  Contrst x-ray urinary tract                       A   0.49   3.52     3.36     3.52NA   3.36 NA  0.04   4.05   3.89   4.05   3.89  1XXX.00.00.0000000             25.5217 090 99      7.08   7.08   0.05
74415TCContrst x-ray urinary tract                       A   0.00   3.32     3.18     3.32NA   3.18 NA  0.01   3.33   3.19   3.33   3.19  1XXX.00.00.0000000             25.5217 020 99      6.88   6.88   0.02
7441526Contrst x-ray urinary tract                       A   0.49   0.20     0.18     0.20     0.18     0.03   0.72   0.70   0.72   0.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74420  Contrst x-ray urinary tract                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      7.04   7.04   0.04
74420TCContrst x-ray urinary tract                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      6.89   6.89   0.01
7442026Contrst x-ray urinary tract                       A   0.36   0.15     0.14     0.15     0.14     0.03   0.54   0.53   0.54   0.53  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74425  Contrst x-ray urinary tract                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      7.04   7.04   0.04
74425TCContrst x-ray urinary tract                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      6.89   6.89   0.01
7442526Contrst x-ray urinary tract                       A   0.36   0.15     0.13     0.15     0.13     0.03   0.54   0.52   0.54   0.52  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74430  Contrast x-ray bladder                            A   0.32   1.47     0.82     1.47NA   0.82 NA  0.02   1.81   1.16   1.81   1.16  1XXX.00.00.0000000             25.5217 090 99      6.98   6.98   0.06
74430TCContrast x-ray bladder                            A   0.00   1.34     0.70     1.34NA   0.70 NA  0.01   1.35   0.71   1.35   0.71  1XXX.00.00.0000000             25.5217 030 99      6.85   6.85   0.05
7443026Contrast x-ray bladder                            A   0.32   0.13     0.12     0.13     0.12     0.01   0.46   0.45   0.46   0.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74440  X-ray male genital tract                          A   0.38   2.15     2.03     2.15NA   2.03 NA  0.04   2.57   2.45   2.57   2.45  1XXX.00.00.0000000             25.5217 090 99      7.03   7.03   0.06
74440TCX-ray male genital tract                          A   0.00   1.99     1.88     1.99NA   1.88 NA  0.01   2.00   1.89   2.00   1.89  1XXX.00.00.0000000             25.5217 030 99      6.87   6.87   0.03
7444026X-ray male genital tract                          A   0.38   0.16     0.15     0.16     0.15     0.03   0.57   0.56   0.57   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74445  X-ray exam of penis                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      7.39   7.39   0.11
74445TCX-ray exam of penis                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      6.89   6.89   0.01
7444526X-ray exam of penis                               A   1.14   0.50     0.45     0.50     0.45     0.10   1.74   1.69   1.74   1.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74450  X-ray urethra/bladder                             C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      7.03   7.03   0.04
74450TCX-ray urethra/bladder                             C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      6.89   6.89   0.01
7445026X-ray urethra/bladder                             A   0.33   0.14     0.12     0.14     0.12     0.03   0.50   0.48   0.50   0.48  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74455  X-ray urethra/bladder                             A   0.33   2.31     2.11     2.31NA   2.11 NA  0.02   2.66   2.46   2.66   2.46  1XXX.00.00.0000000             25.5217 090 99      7.01   7.01   0.04
74455TCX-ray urethra/bladder                             A   0.00   2.17     1.98     2.17NA   1.98 NA  0.01   2.18   1.99   2.18   1.99  1XXX.00.00.0000000             25.5217 030 99      6.87   6.87   0.03
7445526X-ray urethra/bladder                             A   0.33   0.14     0.13     0.14     0.13     0.01   0.48   0.47   0.48   0.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74470  X-ray exam of kidney lesion                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      9.23   9.23   0.05
74470TCX-ray exam of kidney lesion                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      9.00   9.00   0.01
7447026X-ray exam of kidney lesion                       A   0.54   0.23     0.20     0.23     0.20     0.04   0.81   0.78   0.81   0.78  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74475  X-ray control cath insert                         A   0.54   2.74     2.23     2.74NA   2.23 NA  0.04   3.32   2.81   3.32   2.81  1XXX.00.00.0000000             25.5217 090 99     47.47  47.47   0.22
74475TCX-ray control cath insert                         A   0.00   2.51     2.03     2.51NA   2.03 NA  0.01   2.52   2.04   2.52   2.04  1XXX.00.00.0000000             25.5217 030 99     47.24  47.24   0.19
7447526X-ray control cath insert                         A   0.54   0.23     0.20     0.23     0.20     0.03   0.80   0.77   0.80   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74480  X-ray control cath insert                         A   0.54   2.75     2.24     2.75NA   2.24 NA  0.04   3.33   2.82   3.33   2.82  1XXX.00.00.0000000             25.5217 090 99     47.47  47.47   0.22
74480TCX-ray control cath insert                         A   0.00   2.52     2.04     2.52NA   2.04 NA  0.01   2.53   2.05   2.53   2.05  1XXX.00.00.0000000             25.5217 030 99     47.24  47.24   0.19
7448026X-ray control cath insert                         A   0.54   0.23     0.20     0.23     0.20     0.03   0.80   0.77   0.80   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74485  X-ray guide gu dilation                           A   0.54   2.70     2.28     2.70NA   2.28 NA  0.04   3.28   2.86   3.28   2.86  1XXX.00.00.0000000             25.5217 090 99     47.47  47.47   0.22
74485TCX-ray guide gu dilation                           A   0.00   2.47     2.08     2.47NA   2.08 NA  0.01   2.48   2.09   2.48   2.09  1XXX.00.00.0000000             25.5217 030 99     47.24  47.24   0.19
7448526X-ray guide gu dilation                           A   0.54   0.23     0.20     0.23     0.20     0.03   0.80   0.77   0.80   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74710  X-ray measurement of pelvis                       A   0.34   0.82     0.68     0.82NA   0.68 NA  0.02   1.18   1.04   1.18   1.04  1XXX.00.00.0000000             25.5217 090 99      3.07   3.07   0.05
74710TCX-ray measurement of pelvis                       A   0.00   0.68     0.55     0.68NA   0.55 NA  0.01   0.69   0.56   0.69   0.56  1XXX.00.00.0000000             25.5217 010 99      2.93   2.93   0.04
7471026X-ray measurement of pelvis                       A   0.34   0.14     0.13     0.14     0.13     0.01   0.49   0.48   0.49   0.48  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74740  X-ray female genital tract                        A   0.38   1.95     1.85     1.95NA   1.85 NA  0.02   2.35   2.25   2.35   2.25  1XXX.00.00.0000000             25.5217 090 99      9.12   9.12   0.06
74740TCX-ray female genital tract                        A   0.00   1.79     1.70     1.79NA   1.70 NA  0.01   1.80   1.71   1.80   1.71  1XXX.00.00.0000000             25.5217 030 99      8.96   8.96   0.05
7474026X-ray female genital tract                        A   0.38   0.16     0.15     0.16     0.15     0.01   0.55   0.54   0.55   0.54  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74742  X-ray fallopian tube                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74742TCX-ray fallopian tube                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7474226X-ray fallopian tube                              A   0.61   0.25     0.24     0.25     0.24     0.05   0.91   0.90   0.91   0.90  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
74775  X-ray exam of perineum                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      7.15   7.15   0.06
74775TCX-ray exam of perineum                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      6.89   6.89   0.01
7477526X-ray exam of perineum                            A   0.62   0.26     0.23     0.26     0.23     0.05   0.93   0.90   0.93   0.90  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75557  Cardiac mri for morph                             A   2.35  10.81     8.14    10.81NA   8.14 NA  0.11  13.27  10.60  13.27  10.60  1XXX.00.00.0040000             25.5217 090 88     14.48  14.48   0.11
75557TCCardiac mri for morph                             A   0.00   9.75     7.25     9.75NA   7.25 NA  0.01   9.76   7.26   9.76   7.26  1XXX.00.00.0040000             25.5217 010 88     13.42  13.42   0.01
7555726Cardiac mri for morph                             A   2.35   1.06     0.89     1.06     0.89     0.10   3.51   3.34   3.51   3.34  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75559  Cardiac mri w/stress img                          A   2.95  16.11    11.69    16.11NA  11.69 NA  0.13  19.19  14.77  19.19  14.77  1XXX.00.00.0040000             25.5217 090 88     14.82  14.82   0.13
75559TCCardiac mri w/stress img                          A   0.00  14.72    10.56    14.72NA  10.56 NA  0.01  14.73  10.57  14.73  10.57  1XXX.00.00.0040000             25.5217 020 88     13.43  13.43   0.01
7555926Cardiac mri w/stress img                          A   2.95   1.39     1.13     1.39     1.13     0.12   4.46   4.20   4.46   4.20  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75561  Cardiac mri for morph w/dye                       A   2.60  15.24    11.40    15.24NA  11.40 NA  0.12  17.96  14.12  17.96  14.12  1XXX.00.00.0040000             25.5217 090 88     22.06  22.06   0.12
75561TCCardiac mri for morph w/dye                       A   0.00  14.07    10.41    14.07NA  10.41 NA  0.01  14.08  10.42  14.08  10.42  1XXX.00.00.0040000             25.5217 010 88     20.89  20.89   0.01
7556126Cardiac mri for morph w/dye                       A   2.60   1.17     0.99     1.17     0.99     0.11   3.88   3.70   3.88   3.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75563  Card mri w/stress img & dye                       A   3.00  18.75    13.60    18.75NA  13.60 NA  0.12  21.87  16.72  21.87  16.72  1XXX.00.00.0040000             25.5217 090 88     22.37  22.37   0.12
75563TCCard mri w/stress img & dye                       A   0.00  17.28    12.43    17.28NA  12.43 NA  0.01  17.29  12.44  17.29  12.44  1XXX.00.00.0040000             25.5217 010 88     20.90  20.90   0.01
7556326Card mri w/stress img & dye                       A   3.00   1.47     1.17     1.47     1.17     0.11   4.58   4.28   4.58   4.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75565  Card mri veloc flow mapping                       A   0.25   1.93     1.93     1.93NA   1.93 NA  0.02   2.20   2.20   2.20   2.20  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75565TCCard mri veloc flow mapping                       A   0.00   1.82     1.82     1.82NA   1.82 NA  0.01   1.83   1.83   1.83   1.83  1ZZZ.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7556526Card mri veloc flow mapping                       A   0.25   0.11     0.11     0.11     0.11     0.01   0.37   0.37   0.37   0.37  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75571  Ct hrt w/o dye w/ca test                          A   0.58   2.56     2.56     2.56NA   2.56 NA  0.02   3.16   3.16   3.16   3.16  1XXX.00.00.0040000             25.5217 090 88      2.02   2.02   0.02
75571TCCt hrt w/o dye w/ca test                          A   0.00   2.34     2.34     2.34NA   2.34 NA  0.01   2.35   2.35   2.35   2.35  1XXX.00.00.0040000             25.5217 020 88      1.80   1.80   0.01
7557126Ct hrt w/o dye w/ca test                          A   0.58   0.22     0.22     0.22     0.22     0.01   0.81   0.81   0.81   0.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75572  Ct hrt w/3d image                                 A   1.75   6.84     6.84     6.84NA   6.84 NA  0.06   8.65   8.65   8.65   8.65  1XXX.00.00.0040000             25.5217 090 88     10.72  10.72   0.07
75572TCCt hrt w/3d image                                 A   0.00   6.17     6.17     6.17NA   6.17 NA  0.01   6.18   6.18   6.18   6.18  1XXX.00.00.0040000             25.5217 020 88     10.05  10.05   0.02
7557226Ct hrt w/3d image                                 A   1.75   0.67     0.67     0.67     0.67     0.05   2.47   2.47   2.47   2.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75573  Ct hrt w/3d image congen                          A   2.55   9.14     9.14     9.14NA   9.14 NA  0.09  11.78  11.78  11.78  11.78  1XXX.00.00.0040000             25.5217 090 88     11.05  11.05   0.09
75573TCCt hrt w/3d image congen                          A   0.00   8.14     8.14     8.14NA   8.14 NA  0.01   8.15   8.15   8.15   8.15  1XXX.00.00.0040000             25.5217 020 88     10.05  10.05   0.01
7557326Ct hrt w/3d image congen                          A   2.55   1.00     1.00     1.00     1.00     0.08   3.63   3.63   3.63   3.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75574  Ct angio hrt w/3d image                           A   2.40  10.67    10.67    10.67NA  10.67 NA  0.09  13.16  13.16  13.16  13.16  1XXX.00.00.0040000             25.5217 090 88     10.97  10.97   0.09
75574TCCt angio hrt w/3d image                           A   0.00   9.75     9.75     9.75NA   9.75 NA  0.01   9.76   9.76   9.76   9.76  1XXX.00.00.0040000             25.5217 020 88     10.05  10.05   0.01
7557426Ct angio hrt w/3d image                           A   2.40   0.92     0.92     0.92     0.92     0.08   3.40   3.40   3.40   3.40  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75600  Contrast x-ray exam of aorta                      A   0.49   7.48     5.46     7.48NA   5.46 NA  0.04   8.01   5.99   8.01   5.99  1XXX.00.00.0000000             25.5217 090 99     79.53  79.53   0.14
75600TCContrast x-ray exam of aorta                      A   0.00   7.25     5.27     7.25NA   5.27 NA  0.01   7.26   5.28   7.26   5.28  1XXX.00.00.0000000             25.5217 030 99     79.30  79.30   0.11
7560026Contrast x-ray exam of aorta                      A   0.49   0.23     0.19     0.23     0.19     0.03   0.75   0.71   0.75   0.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75605  Contrast x-ray exam of aorta                      A   1.14   5.16     3.19     5.16NA   3.19 NA  0.08   6.38   4.41   6.38   4.41  1XXX.00.00.0000000             25.5217 090 99     79.75  79.75   0.24
75605TCContrast x-ray exam of aorta                      A   0.00   4.65     2.77     4.65NA   2.77 NA  0.01   4.66   2.78   4.66   2.78  1XXX.00.00.0000000             25.5217 030 99     79.24  79.24   0.17
7560526Contrast x-ray exam of aorta                      A   1.14   0.51     0.42     0.51     0.42     0.07   1.72   1.63   1.72   1.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75625  Contrast x-ray exam of aorta                      A   1.14   5.13     3.28     5.13NA   3.28 NA  0.11   6.38   4.53   6.38   4.53  1XXX.00.00.0000000             25.5217 090 99     79.71  79.71   0.27
75625TCContrast x-ray exam of aorta                      A   0.00   4.66     2.87     4.66NA   2.87 NA  0.01   4.67   2.88   4.67   2.88  1XXX.00.00.0000000             25.5217 030 99     79.24  79.24   0.17
7562526Contrast x-ray exam of aorta                      A   1.14   0.47     0.41     0.47     0.41     0.10   1.71   1.65   1.71   1.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75630  X-ray aorta leg arteries                          A   1.79   5.53     3.52     5.53NA   3.52 NA  0.11   7.43   5.42   7.43   5.42  1XXX.00.00.0000000             25.5217 090 99     80.00  80.00   0.27
75630TCX-ray aorta leg arteries                          A   0.00   4.77     2.86     4.77NA   2.86 NA  0.01   4.78   2.87   4.78   2.87  1XXX.00.00.0000000             25.5217 030 99     79.24  79.24   0.17
7563026X-ray aorta leg arteries                          A   1.79   0.76     0.66     0.76     0.66     0.10   2.65   2.55   2.65   2.55  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75635  Ct angio abdominal arteries                       A   2.40  13.51    10.20    13.51NA  10.20 NA  0.15  16.06  12.75  16.06  12.75  1XXX.00.00.0040000             25.5217 090 88     14.26  14.26   0.15
75635TCCt angio abdominal arteries                       A   0.00  12.48     9.30    12.48NA   9.30 NA  0.03  12.51   9.33  12.51   9.33  1XXX.00.00.0040000             25.5217 020 88     13.23  13.23   0.03
7563526Ct angio abdominal arteries                       A   2.40   1.03     0.90     1.03     0.90     0.12   3.55   3.42   3.55   3.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75650  Artery x-rays head & neck                         A   1.49   5.32     3.45     5.32NA   3.45 NA  0.11   6.92   5.05   6.92   5.05  1XXX.00.00.0000000             25.5217 090 99    129.26 129.26   0.37
75650TCArtery x-rays head & neck                         A   0.00   4.69     2.90     4.69NA   2.90 NA  0.01   4.70   2.91   4.70   2.91  1XXX.00.00.0000000             25.5217 030 99    128.63 128.63   0.27
7565026Artery x-rays head & neck                         A   1.49   0.63     0.55     0.63     0.55     0.10   2.22   2.14   2.22   2.14  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75658  Artery x-rays arm                                 A   1.31   5.69     4.07     5.69NA   4.07 NA  0.09   7.09   5.47   7.09   5.47  1XXX.00.00.0000000             25.5217 090 99     79.76  79.76   0.23
75658TCArtery x-rays arm                                 A   0.00   5.18     3.60     5.18NA   3.60 NA  0.01   5.19   3.61   5.19   3.61  1XXX.00.00.0000000             25.5217 030 99     79.25  79.25   0.15
7565826Artery x-rays arm                                 A   1.31   0.51     0.47     0.51     0.47     0.08   1.90   1.86   1.90   1.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75660  Artery x-rays head & neck                         A   1.31   5.84     4.18     5.84NA   4.18 NA  0.05   7.20   5.54   7.20   5.54  1XXX.00.00.0000000             25.5217 090 99    129.24 129.24   0.28
75660TCArtery x-rays head & neck                         A   0.00   5.26     3.65     5.26NA   3.65 NA  0.01   5.27   3.66   5.27   3.66  1XXX.00.00.0000000             25.5217 030 99    128.66 128.66   0.24
7566026Artery x-rays head & neck                         A   1.31   0.58     0.53     0.58     0.53     0.04   1.93   1.88   1.93   1.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75662  Artery x-rays head & neck                         A   1.66   6.80     5.07     6.80NA   5.07 NA  0.10   8.56   6.83   8.56   6.83  1XXX.00.00.0002000             25.5217 090 99    129.02 129.02   0.71
75662TCArtery x-rays head & neck                         A   0.00   6.04     4.40     6.04NA   4.40 NA  0.03   6.07   4.43   6.07   4.43  1XXX.00.00.0002000             25.5217 030 99    128.26 128.26   0.64
7566226Artery x-rays head & neck                         A   1.66   0.76     0.67     0.76     0.67     0.07   2.49   2.40   2.49   2.40  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75665  Artery x-rays head & neck                         A   1.31   6.08     4.42     6.08NA   4.42 NA  0.12   7.51   5.85   7.51   5.85  1XXX.00.00.0000000             25.5217 090 99     79.83  79.83   0.25
75665TCArtery x-rays head & neck                         A   0.00   5.51     3.89     5.51NA   3.89 NA  0.01   5.52   3.90   5.52   3.90  1XXX.00.00.0000000             25.5217 030 99     79.26  79.26   0.14
7566526Artery x-rays head & neck                         A   1.31   0.57     0.53     0.57     0.53     0.11   1.99   1.95   1.99   1.95  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75671  Artery x-rays head & neck                         A   1.66   6.95     5.26     6.95NA   5.26 NA  0.13   8.74   7.05   8.74   7.05  1XXX.00.00.0002000             25.5217 090 99    129.00 129.00   0.72
75671TCArtery x-rays head & neck                         A   0.00   6.23     4.61     6.23NA   4.61 NA  0.03   6.26   4.64   6.26   4.64  1XXX.00.00.0002000             25.5217 030 99    128.28 128.28   0.62
7567126Artery x-rays head & neck                         A   1.66   0.72     0.65     0.72     0.65     0.10   2.48   2.41   2.48   2.41  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75676  Artery x-rays neck                                A   1.31   5.77     4.04     5.77NA   4.04 NA  0.12   7.20   5.47   7.20   5.47  1XXX.00.00.0000000             25.5217 090 99     79.81  79.81   0.26
75676TCArtery x-rays neck                                A   0.00   5.21     3.53     5.21NA   3.53 NA  0.01   5.22   3.54   5.22   3.54  1XXX.00.00.0000000             25.5217 030 99     79.25  79.25   0.15
7567626Artery x-rays neck                                A   1.31   0.56     0.51     0.56     0.51     0.11   1.98   1.93   1.98   1.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75680  Artery x-rays neck                                A   1.66   6.39     4.58     6.39NA   4.58 NA  0.11   8.16   6.35   8.16   6.35  1XXX.00.00.0002000             25.5217 090 99     80.00  80.00   0.24
75680TCArtery x-rays neck                                A   0.00   5.66     3.94     5.66NA   3.94 NA  0.01   5.67   3.95   5.67   3.95  1XXX.00.00.0002000             25.5217 030 99     79.27  79.27   0.14
7568026Artery x-rays neck                                A   1.66   0.73     0.64     0.73     0.64     0.10   2.49   2.40   2.49   2.40  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75685  Artery x-rays spine                               A   1.31   5.83     4.14     5.83NA   4.14 NA  0.09   7.23   5.54   7.23   5.54  1XXX.00.00.0003000             25.5217 090 99     79.83  79.83   0.23
75685TCArtery x-rays spine                               A   0.00   5.26     3.62     5.26NA   3.62 NA  0.01   5.27   3.63   5.27   3.63  1XXX.00.00.0003000             25.5217 030 99     79.26  79.26   0.15
7568526Artery x-rays spine                               A   1.31   0.57     0.52     0.57     0.52     0.08   1.96   1.91   1.96   1.91  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
75705  Artery x-rays spine                               A   2.18   6.17     4.46     6.17NA   4.46 NA  0.08   8.43   6.72   8.43   6.72  1XXX.00.00.0000000             25.5217 090 99     80.20  80.20   0.22
75705TCArtery x-rays spine                               A   0.00   5.23     3.60     5.23NA   3.60 NA  0.01   5.24   3.61   5.24   3.61  1XXX.00.00.0000000             25.5217 030 99     79.26  79.26   0.15
7570526Artery x-rays spine                               A   2.18   0.94     0.86     0.94     0.86     0.07   3.19   3.11   3.19   3.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75710  Artery x-rays arm/leg                             A   1.14   5.71     3.93     5.71NA   3.93 NA  0.06   6.91   5.13   6.91   5.13  1XXX.00.00.0000000             25.5217 090 99     79.73  79.73   0.20
75710TCArtery x-rays arm/leg                             A   0.00   5.24     3.51     5.24NA   3.51 NA  0.01   5.25   3.52   5.25   3.52  1XXX.00.00.0000000             25.5217 030 99     79.26  79.26   0.15
7571026Artery x-rays arm/leg                             A   1.14   0.47     0.42     0.47     0.42     0.05   1.66   1.61   1.66   1.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75716  Artery x-rays arms/legs                           A   1.31   6.55     4.72     6.55NA   4.72 NA  0.13   7.99   6.16   7.99   6.16  1XXX.00.00.0002000             25.5217 090 99     79.55  79.55   0.49
75716TCArtery x-rays arms/legs                           A   0.00   6.01     4.24     6.01NA   4.24 NA  0.03   6.04   4.27   6.04   4.27  1XXX.00.00.0002000             25.5217 030 99     79.01  79.01   0.39
7571626Artery x-rays arms/legs                           A   1.31   0.54     0.48     0.54     0.48     0.10   1.95   1.89   1.95   1.89  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75722  Artery x-rays kidney                              A   1.14   5.48     3.55     5.48NA   3.55 NA  0.08   6.70   4.77   6.70   4.77  1XXX.00.00.0000000             25.5217 090 99     79.75  79.75   0.23
75722TCArtery x-rays kidney                              A   0.00   4.98     3.13     4.98NA   3.13 NA  0.01   4.99   3.14   4.99   3.14  1XXX.00.00.0000000             25.5217 030 99     79.25  79.25   0.16
7572226Artery x-rays kidney                              A   1.14   0.50     0.42     0.50     0.42     0.07   1.71   1.63   1.71   1.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75724  Artery x-rays kidneys                             A   1.49   6.37     4.22     6.37NA   4.22 NA  0.08   7.94   5.79   7.94   5.79  1XXX.00.00.0002000             25.5217 090 99     79.71  79.71   0.47
75724TCArtery x-rays kidneys                             A   0.00   5.65     3.65     5.65NA   3.65 NA  0.03   5.68   3.68   5.68   3.68  1XXX.00.00.0002000             25.5217 030 99     78.99  78.99   0.42
7572426Artery x-rays kidneys                             A   1.49   0.72     0.57     0.72     0.57     0.05   2.26   2.11   2.26   2.11  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75726  Artery x-rays abdomen                             A   1.14   5.63     3.85     5.63NA   3.85 NA  0.09   6.86   5.08   6.86   5.08  1XXX.00.00.0000000             25.5217 090 99     79.72  79.72   0.23
75726TCArtery x-rays abdomen                             A   0.00   5.16     3.44     5.16NA   3.44 NA  0.01   5.17   3.45   5.17   3.45  1XXX.00.00.0000000             25.5217 030 99     79.25  79.25   0.15
7572626Artery x-rays abdomen                             A   1.14   0.47     0.41     0.47     0.41     0.08   1.69   1.63   1.69   1.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75731  Artery x-rays adrenal gland                       A   1.14   5.77     3.82     5.77NA   3.82 NA  0.05   6.96   5.01   6.96   5.01  1XXX.00.00.0000000             25.5217 090 99     79.79  79.79   0.19
75731TCArtery x-rays adrenal gland                       A   0.00   5.24     3.39     5.24NA   3.39 NA  0.01   5.25   3.40   5.25   3.40  1XXX.00.00.0000000             25.5217 030 99     79.26  79.26   0.15
7573126Artery x-rays adrenal gland                       A   1.14   0.53     0.43     0.53     0.43     0.04   1.71   1.61   1.71   1.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75733  Artery x-rays adrenals                            A   1.31   6.64     4.46     6.64NA   4.46 NA  0.07   8.02   5.84   8.02   5.84  1XXX.00.00.0002000             25.5217 090 99     79.65  79.65   0.44
75733TCArtery x-rays adrenals                            A   0.00   6.00     3.95     6.00NA   3.95 NA  0.03   6.03   3.98   6.03   3.98  1XXX.00.00.0002000             25.5217 030 99     79.01  79.01   0.40
7573326Artery x-rays adrenals                            A   1.31   0.64     0.51     0.64     0.51     0.04   1.99   1.86   1.99   1.86  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75736  Artery x-rays pelvis                              A   1.14   5.63     3.78     5.63NA   3.78 NA  0.06   6.83   4.98   6.83   4.98  1XXX.00.00.0000000             25.5217 090 99     79.73  79.73   0.20
75736TCArtery x-rays pelvis                              A   0.00   5.15     3.36     5.15NA   3.36 NA  0.01   5.16   3.37   5.16   3.37  1XXX.00.00.0000000             25.5217 030 99     79.25  79.25   0.15
7573626Artery x-rays pelvis                              A   1.14   0.48     0.42     0.48     0.42     0.05   1.67   1.61   1.67   1.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75741  Artery x-rays lung                                A   1.31   5.09     3.27     5.09NA   3.27 NA  0.09   6.49   4.67   6.49   4.67  1XXX.00.00.0000000             25.5217 090 99     79.78  79.78   0.25
75741TCArtery x-rays lung                                A   0.00   4.54     2.80     4.54NA   2.80 NA  0.01   4.55   2.81   4.55   2.81  1XXX.00.00.0000000             25.5217 030 99     79.23  79.23   0.17
7574126Artery x-rays lung                                A   1.31   0.55     0.47     0.55     0.47     0.08   1.94   1.86   1.94   1.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75743  Artery x-rays lungs                               A   1.66   5.49     3.66     5.49NA   3.66 NA  0.11   7.26   5.43   7.26   5.43  1XXX.00.00.0002000             25.5217 090 99     79.94  79.94   0.27
75743TCArtery x-rays lungs                               A   0.00   4.79     3.06     4.79NA   3.06 NA  0.01   4.80   3.07   4.80   3.07  1XXX.00.00.0002000             25.5217 030 99     79.24  79.24   0.17
7574326Artery x-rays lungs                               A   1.66   0.70     0.60     0.70     0.60     0.10   2.46   2.36   2.46   2.36  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75746  Artery x-rays lung                                A   1.14   5.42     3.63     5.42NA   3.63 NA  0.08   6.64   4.85   6.64   4.85  1XXX.00.00.0000000             25.5217 090 99     28.58  28.58   0.13
75746TCArtery x-rays lung                                A   0.00   4.94     3.20     4.94NA   3.20 NA  0.01   4.95   3.21   4.95   3.21  1XXX.00.00.0000000             25.5217 030 99     28.10  28.10   0.06
7574626Artery x-rays lung                                A   1.14   0.48     0.43     0.48     0.43     0.07   1.69   1.64   1.69   1.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75756  Artery x-rays chest                               A   1.14   5.79     3.83     5.79NA   3.83 NA  0.23   7.16   5.20   7.16   5.20  1XXX.00.00.0000000             25.5217 090 99     28.65  28.65   0.27
75756TCArtery x-rays chest                               A   0.00   5.25     3.41     5.25NA   3.41 NA  0.01   5.26   3.42   5.26   3.42  1XXX.00.00.0000000             25.5217 030 99     28.11  28.11   0.05
7575626Artery x-rays chest                               A   1.14   0.54     0.42     0.54     0.42     0.22   1.90   1.78   1.90   1.78  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75774  Artery x-ray each vessel                          A   0.36   4.31     2.51     4.31NA   2.51 NA  0.04   4.71   2.91   4.71   2.91  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75774TCArtery x-ray each vessel                          A   0.00   4.16     2.38     4.16NA   2.38 NA  0.01   4.17   2.39   4.17   2.39  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7577426Artery x-ray each vessel                          A   0.36   0.15     0.13     0.15     0.13     0.03   0.54   0.52   0.54   0.52  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75791  Av dialysis shunt imaging                         A   1.71   7.88     7.88     7.88NA   7.88 NA  0.11   9.70   9.70   9.70   9.70  1XXX.00.00.0000000             25.5217 090 99      6.96   6.96   0.11
75791TCAv dialysis shunt imaging                         A   0.00   7.25     7.25     7.25NA   7.25 NA  0.01   7.26   7.26   7.26   7.26  1XXX.00.00.0000000             25.5217 030 99      6.33   6.33   0.01
7579126Av dialysis shunt imaging                         A   1.71   0.63     0.63     0.63     0.63     0.10   2.44   2.44   2.44   2.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75801  Lymph vessel x-ray arm/leg                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     16.27  16.27   0.19
75801TCLymph vessel x-ray arm/leg                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99     15.94  15.94   0.01
7580126Lymph vessel x-ray arm/leg                        A   0.81   0.33     0.35     0.33     0.35     0.18   1.32   1.34   1.32   1.34  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75803  Lymph vessel x-ray arms/legs                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0002000             25.5217 090 99     16.44  16.44   0.11
75803TCLymph vessel x-ray arms/legs                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0002000             25.5217 030 99     15.94  15.94   0.01
7580326Lymph vessel x-ray arms/legs                      A   1.17   0.50     0.44     0.50     0.44     0.10   1.77   1.71   1.77   1.71  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75805  Lymph vessel x-ray trunk                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     16.28  16.28   0.08
75805TCLymph vessel x-ray trunk                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99     15.94  15.94   0.01
7580526Lymph vessel x-ray trunk                          A   0.81   0.34     0.31     0.34     0.31     0.07   1.22   1.19   1.22   1.19  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75807  Lymph vessel x-ray trunk                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0002000             25.5217 090 99     16.44  16.44   0.11
75807TCLymph vessel x-ray trunk                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0002000             25.5217 030 99     15.94  15.94   0.01
7580726Lymph vessel x-ray trunk                          A   1.17   0.50     0.45     0.50     0.45     0.10   1.77   1.72   1.77   1.72  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75809  Nonvascular shunt x-ray                           A   0.47   2.39     2.50     2.39NA   2.50 NA  0.04   2.90   3.01   2.90   3.01  1XXX.00.00.0000000             25.5217 090 99      3.16   3.16   0.04
75809TCNonvascular shunt x-ray                           A   0.00   2.19     2.31     2.19NA   2.31 NA  0.01   2.20   2.32   2.20   2.32  1XXX.00.00.0000000             25.5217 030 99      2.96   2.96   0.01
7580926Nonvascular shunt x-ray                           A   0.47   0.20     0.19     0.20     0.19     0.03   0.70   0.69   0.70   0.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75810  Vein x-ray spleen/liver                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     79.89  79.89   0.11
75810TCVein x-ray spleen/liver                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99     79.40  79.40   0.01
7581026Vein x-ray spleen/liver                           A   1.14   0.49     0.43     0.49     0.43     0.10   1.73   1.67   1.73   1.67  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75820  Vein x-ray arm/leg                                A   0.70   2.98     2.90     2.98NA   2.90 NA  0.05   3.73   3.65   3.73   3.65  1XXX.00.00.0000000             25.5217 090 99     28.36  28.36   0.14
75820TCVein x-ray arm/leg                                A   0.00   2.68     2.64     2.68NA   2.64 NA  0.01   2.69   2.65   2.69   2.65  1XXX.00.00.0000000             25.5217 030 99     28.06  28.06   0.10
7582026Vein x-ray arm/leg                                A   0.70   0.30     0.26     0.30     0.26     0.04   1.04   1.00   1.04   1.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75822  Vein x-ray arms/legs                              A   1.06   3.42     3.37     3.42NA   3.37 NA  0.08   4.56   4.51   4.56   4.51  1XXX.00.00.0002000             25.5217 090 99     28.50  28.50   0.16
75822TCVein x-ray arms/legs                              A   0.00   2.99     2.98     2.99NA   2.98 NA  0.01   3.00   2.99   3.00   2.99  1XXX.00.00.0002000             25.5217 030 99     28.07  28.07   0.09
7582226Vein x-ray arms/legs                              A   1.06   0.43     0.39     0.43     0.39     0.07   1.56   1.52   1.56   1.52  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75825  Vein x-ray trunk                                  A   1.14   4.89     3.11     4.89NA   3.11 NA  0.09   6.12   4.34   6.12   4.34  1XXX.00.00.0000000             25.5217 090 99     79.69  79.69   0.26
75825TCVein x-ray trunk                                  A   0.00   4.43     2.70     4.43NA   2.70 NA  0.01   4.44   2.71   4.44   2.71  1XXX.00.00.0000000             25.5217 030 99     79.23  79.23   0.18
7582526Vein x-ray trunk                                  A   1.14   0.46     0.41     0.46     0.41     0.08   1.68   1.63   1.68   1.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75827  Vein x-ray chest                                  A   1.14   4.96     3.28     4.96NA   3.28 NA  0.08   6.18   4.50   6.18   4.50  1XXX.00.00.0000000             25.5217 090 99     28.54  28.54   0.13
75827TCVein x-ray chest                                  A   0.00   4.52     2.87     4.52NA   2.87 NA  0.01   4.53   2.88   4.53   2.88  1XXX.00.00.0000000             25.5217 030 99     28.10  28.10   0.06
7582726Vein x-ray chest                                  A   1.14   0.44     0.41     0.44     0.41     0.07   1.65   1.62   1.65   1.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75831  Vein x-ray kidney                                 A   1.14   4.99     3.22     4.99NA   3.22 NA  0.25   6.38   4.61   6.38   4.61  1XXX.00.00.0000000             25.5217 090 99     79.69  79.69   0.41
75831TCVein x-ray kidney                                 A   0.00   4.53     2.81     4.53NA   2.81 NA  0.01   4.54   2.82   4.54   2.82  1XXX.00.00.0000000             25.5217 030 99     79.23  79.23   0.17
7583126Vein x-ray kidney                                 A   1.14   0.46     0.41     0.46     0.41     0.24   1.84   1.79   1.84   1.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75833  Vein x-ray kidneys                                A   1.49   5.59     3.86     5.59NA   3.86 NA  0.09   7.17   5.44   7.17   5.44  1XXX.00.00.0002000             25.5217 090 99     79.83  79.83   0.24
75833TCVein x-ray kidneys                                A   0.00   5.01     3.34     5.01NA   3.34 NA  0.01   5.02   3.35   5.02   3.35  1XXX.00.00.0002000             25.5217 030 99     79.25  79.25   0.16
7583326Vein x-ray kidneys                                A   1.49   0.58     0.52     0.58     0.52     0.08   2.15   2.09   2.15   2.09  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75840  Vein x-ray adrenal gland                          A   1.14   4.87     3.07     4.87NA   3.07 NA  0.25   6.26   4.46   6.26   4.46  1XXX.00.00.0000000             25.5217 090 99     79.66  79.66   0.42
75840TCVein x-ray adrenal gland                          A   0.00   4.44     2.69     4.44NA   2.69 NA  0.01   4.45   2.70   4.45   2.70  1XXX.00.00.0000000             25.5217 030 99     79.23  79.23   0.18
7584026Vein x-ray adrenal gland                          A   1.14   0.43     0.38     0.43     0.38     0.24   1.81   1.76   1.81   1.76  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75842  Vein x-ray adrenal glands                         A   1.49   5.60     3.81     5.60NA   3.81 NA  0.09   7.18   5.39   7.18   5.39  1XXX.00.00.0002000             25.5217 090 99     79.87  79.87   0.24
75842TCVein x-ray adrenal glands                         A   0.00   4.98     3.25     4.98NA   3.25 NA  0.01   4.99   3.26   4.99   3.26  1XXX.00.00.0002000             25.5217 030 99     79.25  79.25   0.16
7584226Vein x-ray adrenal glands                         A   1.49   0.62     0.56     0.62     0.56     0.08   2.19   2.13   2.19   2.13  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
75860  Vein x-ray neck                                   A   1.14   5.08     3.21     5.08NA   3.21 NA  0.09   6.31   4.44   6.31   4.44  1XXX.00.00.0000000             25.5217 090 99     28.60  28.60   0.14
75860TCVein x-ray neck                                   A   0.00   4.58     2.78     4.58NA   2.78 NA  0.01   4.59   2.79   4.59   2.79  1XXX.00.00.0000000             25.5217 030 99     28.10  28.10   0.06
7586026Vein x-ray neck                                   A   1.14   0.50     0.43     0.50     0.43     0.08   1.72   1.65   1.72   1.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75870  Vein x-ray skull                                  A   1.14   5.01     3.16     5.01NA   3.16 NA  0.08   6.23   4.38   6.23   4.38  1XXX.00.00.0000000             25.5217 090 99     28.57  28.57   0.13
75870TCVein x-ray skull                                  A   0.00   4.54     2.73     4.54NA   2.73 NA  0.01   4.55   2.74   4.55   2.74  1XXX.00.00.0000000             25.5217 030 99     28.10  28.10   0.06
7587026Vein x-ray skull                                  A   1.14   0.47     0.43     0.47     0.43     0.07   1.68   1.64   1.68   1.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75872  Vein x-ray skull                                  A   1.14   7.19     6.73     7.19NA   6.73 NA  0.08   8.41   7.95   8.41   7.95  1XXX.00.00.0000000             25.5217 090 99     28.71  28.71   0.11
75872TCVein x-ray skull                                  A   0.00   6.60     6.10     6.60NA   6.10 NA  0.01   6.61   6.11   6.61   6.11  1XXX.00.00.0000000             25.5217 030 99     28.12  28.12   0.04
7587226Vein x-ray skull                                  A   1.14   0.59     0.63     0.59     0.63     0.07   1.80   1.84   1.80   1.84  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75880  Vein x-ray eye socket                             A   0.70   4.34     5.54     4.34NA   5.54 NA  0.05   5.09   6.29   5.09   6.29  1XXX.00.00.0000000             25.5217 090 99     28.41  28.41   0.11
75880TCVein x-ray eye socket                             A   0.00   4.02     5.20     4.02NA   5.20 NA  0.01   4.03   5.21   4.03   5.21  1XXX.00.00.0000000             25.5217 030 99     28.09  28.09   0.07
7588026Vein x-ray eye socket                             A   0.70   0.32     0.34     0.32     0.34     0.04   1.06   1.08   1.06   1.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75885  Vein x-ray liver                                  A   1.44   5.12     3.30     5.12NA   3.30 NA  0.09   6.65   4.83   6.65   4.83  1XXX.00.00.0000000             25.5217 090 99     79.83  79.83   0.26
75885TCVein x-ray liver                                  A   0.00   4.52     2.78     4.52NA   2.78 NA  0.01   4.53   2.79   4.53   2.79  1XXX.00.00.0000000             25.5217 030 99     79.23  79.23   0.18
7588526Vein x-ray liver                                  A   1.44   0.60     0.52     0.60     0.52     0.08   2.12   2.04   2.12   2.04  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75887  Vein x-ray liver                                  A   1.44   5.21     3.39     5.21NA   3.39 NA  0.06   6.71   4.89   6.71   4.89  1XXX.00.00.0000000             25.5217 090 99     28.71  28.71   0.11
75887TCVein x-ray liver                                  A   0.00   4.60     2.86     4.60NA   2.86 NA  0.01   4.61   2.87   4.61   2.87  1XXX.00.00.0000000             25.5217 030 99     28.10  28.10   0.06
7588726Vein x-ray liver                                  A   1.44   0.61     0.53     0.61     0.53     0.05   2.10   2.02   2.10   2.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75889  Vein x-ray liver                                  A   1.14   5.00     3.22     5.00NA   3.22 NA  0.08   6.22   4.44   6.22   4.44  1XXX.00.00.0000000             25.5217 090 99     79.70  79.70   0.24
75889TCVein x-ray liver                                  A   0.00   4.53     2.81     4.53NA   2.81 NA  0.01   4.54   2.82   4.54   2.82  1XXX.00.00.0000000             25.5217 030 99     79.23  79.23   0.17
7588926Vein x-ray liver                                  A   1.14   0.47     0.41     0.47     0.41     0.07   1.68   1.62   1.68   1.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75891  Vein x-ray liver                                  A   1.14   5.00     3.22     5.00NA   3.22 NA  0.08   6.22   4.44   6.22   4.44  1XXX.00.00.0000000             25.5217 090 99     79.70  79.70   0.24
75891TCVein x-ray liver                                  A   0.00   4.53     2.81     4.53NA   2.81 NA  0.01   4.54   2.82   4.54   2.82  1XXX.00.00.0000000             25.5217 030 99     79.23  79.23   0.17
7589126Vein x-ray liver                                  A   1.14   0.47     0.41     0.47     0.41     0.07   1.68   1.62   1.68   1.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75893  Venous sampling by catheter                       A   0.54   4.72     2.95     4.72NA   2.95 NA  0.02   5.28   3.51   5.28   3.51  1XXX.00.00.0000000             25.5217 090 99     79.45  79.45   0.19
75893TCVenous sampling by catheter                       A   0.00   4.50     2.75     4.50NA   2.75 NA  0.01   4.51   2.76   4.51   2.76  1XXX.00.00.0000000             25.5217 030 99     79.23  79.23   0.18
7589326Venous sampling by catheter                       A   0.54   0.22     0.20     0.22     0.20     0.01   0.77   0.75   0.77   0.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75894  X-rays transcath therapy                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75894TCX-rays transcath therapy                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7589426X-rays transcath therapy                          A   1.31   0.54     0.48     0.54     0.48     0.16   2.01   1.95   2.01   1.95  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75896  X-rays transcath therapy                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75896TCX-rays transcath therapy                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7589626X-rays transcath therapy                          A   1.31   0.56     0.48     0.56     0.48     0.16   2.03   1.95   2.03   1.95  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75898  Follow-up angiography                             C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      3.67   3.67   0.21
75898TCFollow-up angiography                             C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      2.96   2.96   0.01
7589826Follow-up angiography                             A   1.65   0.71     0.62     0.71     0.62     0.20   2.56   2.47   2.56   2.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75900  Intravascular cath exchange                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75900TCIntravascular cath exchange                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7590026Intravascular cath exchange                       A   0.49   0.20     0.17     0.20     0.17     0.05   0.74   0.71   0.74   0.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75901  Remove cva device obstruct                        A   0.49   4.43     4.58     4.43NA   4.58 NA  0.04   4.96   5.11   4.96   5.11  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
75901TCRemove cva device obstruct                        A   0.00   4.23     4.40     4.23NA   4.40 NA  0.01   4.24   4.41   4.24   4.41  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7590126Remove cva device obstruct                        A   0.49   0.20     0.18     0.20     0.18     0.03   0.72   0.70   0.72   0.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75902  Remove cva lumen obstruct                         A   0.39   1.86     1.77     1.86NA   1.77 NA  0.05   2.30   2.21   2.30   2.21  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
75902TCRemove cva lumen obstruct                         A   0.00   1.70     1.63     1.70NA   1.63 NA  0.01   1.71   1.64   1.71   1.64  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7590226Remove cva lumen obstruct                         A   0.39   0.16     0.14     0.16     0.14     0.04   0.59   0.57   0.59   0.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75940  X-ray placement vein filter                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75940TCX-ray placement vein filter                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7594026X-ray placement vein filter                       A   0.54   0.21     0.20     0.21     0.20     0.07   0.82   0.81   0.82   0.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75945  Intravascular us                                  C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      6.14   6.14   0.06
75945TCIntravascular us                                  C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      5.98   5.98   0.01
7594526Intravascular us                                  A   0.40   0.16     0.14     0.16     0.14     0.05   0.61   0.59   0.61   0.59  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75946  Intravascular us add-on                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75946TCIntravascular us add-on                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7594626Intravascular us add-on                           A   0.40   0.15     0.13     0.15     0.13     0.07   0.62   0.60   0.62   0.60  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75952  Endovasc repair abdom aorta                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75952TCEndovasc repair abdom aorta                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7595226Endovasc repair abdom aorta                       A   4.49   1.64     1.55     1.64     1.55     0.86   6.99   6.90   6.99   6.90  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75953  Abdom aneurysm endovas rpr                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75953TCAbdom aneurysm endovas rpr                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7595326Abdom aneurysm endovas rpr                        A   1.36   0.50     0.47     0.50     0.47     0.27   2.13   2.10   2.13   2.10  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75954  Iliac aneurysm endovas rpr                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
75954TCIliac aneurysm endovas rpr                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7595426Iliac aneurysm endovas rpr                        A   2.25   0.83     0.79     0.83     0.79     0.41   3.49   3.45   3.49   3.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75956  Xray endovasc thor ao repr                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75956TCXray endovasc thor ao repr                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7595626Xray endovasc thor ao repr                        A   7.00   2.55     2.35     2.55     2.35     1.44  10.99  10.79  10.99  10.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75957  Xray endovasc thor ao repr                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75957TCXray endovasc thor ao repr                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7595726Xray endovasc thor ao repr                        A   6.00   2.19     2.02     2.19     2.02     1.21   9.40   9.23   9.40   9.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75958  Xray place prox ext thor ao                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75958TCXray place prox ext thor ao                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7595826Xray place prox ext thor ao                       A   4.00   1.42     1.34     1.42     1.34     0.81   6.23   6.15   6.23   6.15  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75959  Xray place dist ext thor ao                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75959TCXray place dist ext thor ao                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7595926Xray place dist ext thor ao                       A   3.50   1.20     1.05     1.20     1.05     0.83   5.53   5.38   5.53   5.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75960  Transcath iv stent rs&i                           A   0.82   4.86     2.70     4.86NA   2.70 NA  0.06   5.74   3.58   5.74   3.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75960TCTranscath iv stent rs&i                           A   0.00   4.52     2.40     4.52NA   2.40 NA  0.01   4.53   2.41   4.53   2.41  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7596026Transcath iv stent rs&i                           A   0.82   0.34     0.30     0.34     0.30     0.05   1.21   1.17   1.21   1.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75961  Retrieval broken catheter                         A   4.24   6.40     4.79     6.40NA   4.79 NA  0.28  10.92   9.31  10.92   9.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75961TCRetrieval broken catheter                         A   0.00   4.67     3.27     4.67NA   3.27 NA  0.01   4.68   3.28   4.68   3.28  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7596126Retrieval broken catheter                         A   4.24   1.73     1.52     1.73     1.52     0.27   6.24   6.03   6.24   6.03  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75962  Repair arterial blockage                          A   0.54   5.71     3.47     5.71NA   3.47 NA  0.04   6.29   4.05   6.29   4.05  1XXX.00.00.0000000             25.5217 090 99    148.07 148.07   0.30
75962TCRepair arterial blockage                          A   0.00   5.49     3.27     5.49NA   3.27 NA  0.01   5.50   3.28   5.50   3.28  1XXX.00.00.0000000             25.5217 030 99    147.85 147.85   0.27
7596226Repair arterial blockage                          A   0.54   0.22     0.20     0.22     0.20     0.03   0.79   0.77   0.79   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75964  Repair artery blockage each                       A   0.36   3.52     2.35     3.52NA   2.35 NA  0.05   3.93   2.76   3.93   2.76  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75964TCRepair artery blockage each                       A   0.00   3.38     2.22     3.38NA   2.22 NA  0.01   3.39   2.23   3.39   2.23  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7596426Repair artery blockage each                       A   0.36   0.14     0.13     0.14     0.13     0.04   0.54   0.53   0.54   0.53  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75966  Repair arterial blockage                          A   1.31   6.17     3.72     6.17NA   3.72 NA  0.08   7.56   5.11   7.56   5.11  1XXX.00.00.0000000             25.5217 090 99    148.43 148.43   0.33
75966TCRepair arterial blockage                          A   0.00   5.59     3.23     5.59NA   3.23 NA  0.01   5.60   3.24   5.60   3.24  1XXX.00.00.0000000             25.5217 030 99    147.85 147.85   0.26
7596626Repair arterial blockage                          A   1.31   0.58     0.49     0.58     0.49     0.07   1.96   1.87   1.96   1.87  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75968  Repair artery blockage each                       A   0.36   3.46     2.21     3.46NA   2.21 NA  0.02   3.84   2.59   3.84   2.59  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75968TCRepair artery blockage each                       A   0.00   3.30     2.08     3.30NA   2.08 NA  0.01   3.31   2.09   3.31   2.09  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7596826Repair artery blockage each                       A   0.36   0.16     0.13     0.16     0.13     0.01   0.53   0.50   0.53   0.50  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75970  Vascular biopsy                                   C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75970TCVascular biopsy                                   C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7597026Vascular biopsy                                   A   0.83   0.35     0.30     0.35     0.30     0.07   1.25   1.20   1.25   1.20  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75978  Repair venous blockage                            A   0.54   5.73     3.64     5.73NA   3.64 NA  0.04   6.31   4.22   6.31   4.22  1XXX.00.00.0000000             25.5217 090 99     98.51  98.51   0.21
75978TCRepair venous blockage                            A   0.00   5.51     3.44     5.51NA   3.44 NA  0.01   5.52   3.45   5.52   3.45  1XXX.00.00.0000000             25.5217 030 99     98.29  98.29   0.18
7597826Repair venous blockage                            A   0.54   0.22     0.20     0.22     0.20     0.03   0.79   0.77   0.79   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75980  Contrast xray exam bile duct                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75980TCContrast xray exam bile duct                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7598026Contrast xray exam bile duct                      A   1.44   0.60     0.53     0.60     0.53     0.12   2.16   2.09   2.16   2.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75982  Contrast xray exam bile duct                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75982TCContrast xray exam bile duct                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7598226Contrast xray exam bile duct                      A   1.44   0.60     0.52     0.60     0.52     0.12   2.16   2.08   2.16   2.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75984  Xray control catheter change                      A   0.72   2.64     2.46     2.64NA   2.46 NA  0.05   3.41   3.23   3.41   3.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75984TCXray control catheter change                      A   0.00   2.34     2.20     2.34NA   2.20 NA  0.01   2.35   2.21   2.35   2.21  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7598426Xray control catheter change                      A   0.72   0.30     0.26     0.30     0.26     0.04   1.06   1.02   1.06   1.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75989  Abscess drainage under x-ray                      A   1.19   2.78     2.38     2.78NA   2.38 NA  0.06   4.03   3.63   4.03   3.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
75989TCAbscess drainage under x-ray                      A   0.00   2.28     1.94     2.28NA   1.94 NA  0.01   2.29   1.95   2.29   1.95  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7598926Abscess drainage under x-ray                      A   1.19   0.50     0.44     0.50     0.44     0.05   1.74   1.68   1.74   1.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76000  Fluoroscope examination                           A   0.17   2.10     1.30     2.10NA   1.30 NA  0.02   2.29   1.49   2.29   1.49  1XXX.00.00.0000000             25.5217 090 99      3.33   3.33   0.03
76000TCFluoroscope examination                           A   0.00   2.03     1.23     2.03NA   1.23 NA  0.01   2.04   1.24   2.04   1.24  1XXX.00.00.0000000             25.5217 030 99      3.26   3.26   0.02
7600026Fluoroscope examination                           A   0.17   0.07     0.07     0.07     0.07     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76001  Fluoroscope exam extensive                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76001TCFluoroscope exam extensive                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7600126Fluoroscope exam extensive                        A   0.67   0.30     0.30     0.30     0.30     0.08   1.05   1.05   1.05   1.05  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76010  X-ray nose to rectum                              A   0.18   0.63     0.56     0.63NA   0.56 NA  0.02   0.83   0.76   0.83   0.76  1XXX.00.00.0000000             25.5217 090 99      1.81   1.81   0.04
76010TCX-ray nose to rectum                              A   0.00   0.55     0.49     0.55NA   0.49 NA  0.01   0.56   0.50   0.56   0.50  1XXX.00.00.0000000             25.5217 010 99      1.73   1.73   0.03
7601026X-ray nose to rectum                              A   0.18   0.08     0.07     0.08     0.07     0.01   0.27   0.26   0.27   0.26  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76080  X-ray exam of fistula                             A   0.54   1.27     1.15     1.27NA   1.15 NA  0.04   1.85   1.73   1.85   1.73  1XXX.00.00.0000000             25.5217 090 99      9.15   9.15   0.12
76080TCX-ray exam of fistula                             A   0.00   1.04     0.95     1.04NA   0.95 NA  0.01   1.05   0.96   1.05   0.96  1XXX.00.00.0000000             25.5217 030 99      8.92   8.92   0.09
7608026X-ray exam of fistula                             A   0.54   0.23     0.20     0.23     0.20     0.03   0.80   0.77   0.80   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76098  X-ray exam breast specimen                        A   0.16   0.39     0.33     0.39NA   0.33 NA  0.02   0.57   0.51   0.57   0.51  1XXX.00.00.0000000             25.5217 090 99     15.54  15.54   0.49
76098TCX-ray exam breast specimen                        A   0.00   0.32     0.27     0.32NA   0.27 NA  0.01   0.33   0.28   0.33   0.28  1XXX.00.00.0000000             25.5217 010 99     15.47  15.47   0.48
7609826X-ray exam breast specimen                        A   0.16   0.07     0.06     0.07     0.06     0.01   0.24   0.23   0.24   0.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76100  X-ray exam of body section                        A   0.58   3.00     2.34     3.00NA   2.34 NA  0.06   3.64   2.98   3.64   2.98  1XXX.00.00.0000000             25.5217 090 99      3.24   3.24   0.06
76100TCX-ray exam of body section                        A   0.00   2.72     2.03     2.72NA   2.03 NA  0.01   2.73   2.04   2.73   2.04  1XXX.00.00.0000000             25.5217 010 99      2.96   2.96   0.01
7610026X-ray exam of body section                        A   0.58   0.28     0.31     0.28     0.31     0.05   0.91   0.94   0.91   0.94  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76101  Complex body section x-ray                        A   0.58   4.56     3.73     4.56NA   3.73 NA  0.09   5.23   4.40   5.23   4.40  1XXX.00.00.0000000             25.5217 090 99      9.32   9.32   0.10
76101TCComplex body section x-ray                        A   0.00   4.23     3.32     4.23NA   3.32 NA  0.01   4.24   3.33   4.24   3.33  1XXX.00.00.0000000             25.5217 020 99      8.99   8.99   0.02
7610126Complex body section x-ray                        A   0.58   0.33     0.41     0.33     0.41     0.08   0.99   1.07   0.99   1.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76102  Complex body section x-rays                       A   0.58   6.35     5.21     6.35NA   5.21 NA  0.11   7.04   5.90   7.04   5.90  1XXX.00.00.0002000             25.5217 090 99      9.33   9.33   0.11
76102TCComplex body section x-rays                       A   0.00   6.02     4.79     6.02NA   4.79 NA  0.01   6.03   4.80   6.03   4.80  1XXX.00.00.0002000             25.5217 020 99      9.00   9.00   0.01
7610226Complex body section x-rays                       A   0.58   0.33     0.42     0.33     0.42     0.10   1.01   1.10   1.01   1.10  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
76120  Cine/video x-rays                                 A   0.38   1.86     1.74     1.86NA   1.74 NA  0.04   2.28   2.16   2.28   2.16  1XXX.00.00.0000000             25.5217 090 99      3.40   3.40   0.05
76120TCCine/video x-rays                                 A   0.00   1.71     1.59     1.71NA   1.59 NA  0.01   1.72   1.60   1.72   1.60  1XXX.00.00.0000000             25.5217 020 99      3.25   3.25   0.02
7612026Cine/video x-rays                                 A   0.38   0.15     0.15     0.15     0.15     0.03   0.56   0.56   0.56   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76125  Cine/video x-rays add-on                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76125TCCine/video x-rays add-on                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
7612526Cine/video x-rays add-on                          A   0.27   0.13     0.11     0.13     0.11     0.03   0.43   0.41   0.43   0.41  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76140  X-ray consultation                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
76376  3d render w/o postprocess                         A   0.20   1.90     1.46     1.90NA   1.46 NA  0.02   2.12   1.68   2.12   1.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76376TC3d render w/o postprocess                         A   0.00   1.81     1.38     1.81NA   1.38 NA  0.01   1.82   1.39   1.82   1.39  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
76376263d render w/o postprocess                         A   0.20   0.09     0.08     0.09     0.08     0.01   0.30   0.29   0.30   0.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76377  3d rendering w/postprocess                        A   0.79   1.93     1.43     1.93NA   1.43 NA  0.05   2.77   2.27   2.77   2.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76377TC3d rendering w/postprocess                        A   0.00   1.60     1.13     1.60NA   1.13 NA  0.01   1.61   1.14   1.61   1.14  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
76377263d rendering w/postprocess                        A   0.79   0.33     0.30     0.33     0.30     0.04   1.16   1.13   1.16   1.13  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76380  CAT scan follow-up study                          A   0.98   4.59     3.71     4.59NA   3.71 NA  0.05   5.62   4.74   5.62   4.74  1XXX.00.00.0000000             25.5217 090 99      4.85   4.85   0.05
76380TCCAT scan follow-up study                          A   0.00   4.18     3.33     4.18NA   3.33 NA  0.01   4.19   3.34   4.19   3.34  1XXX.00.00.0000000             25.5217 010 99      4.44   4.44   0.01
7638026CAT scan follow-up study                          A   0.98   0.41     0.38     0.41     0.38     0.04   1.43   1.40   1.43   1.40  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76390  Mr spectroscopy                                   N+  1.40  12.57    11.95    12.57NA  11.95 NA  0.06  14.03  13.41  14.03  13.41  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
76390TCMr spectroscopy                                   N+  0.00  11.97    11.33    11.97NA  11.33 NA  0.01  11.98  11.34  11.98  11.34  1XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
7639026Mr spectroscopy                                   N+  1.40   0.60     0.62     0.60     0.62     0.05   2.05   2.07   2.05   2.07  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
76496  Fluoroscopic procedure                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
76496TCFluoroscopic procedure                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      3.26   3.26   0.01
7649626Fluoroscopic procedure                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76497  Ct procedure                                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
76497TCCt procedure                                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 020 99      4.44   4.44   0.01
7649726Ct procedure                                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76498  Mri procedure                                     C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
76498TCMri procedure                                     C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 020 99     13.43  13.43   0.01
7649826Mri procedure                                     C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76499  Radiographic procedure                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76499TCRadiographic procedure                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      1.75   1.75   0.01
7649926Radiographic procedure                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76506  Echo exam of head                                 A   0.63   2.91     2.83     2.91NA   2.83 NA  0.05   3.59   3.51   3.59   3.51  1XXX.00.00.0000000             25.5217 090 99      2.69   2.69   0.05
76506TCEcho exam of head                                 A   0.00   2.65     2.59     2.65NA   2.59 NA  0.01   2.66   2.60   2.66   2.60  1XXX.00.00.0000000             25.5217 010 99      2.43   2.43   0.01
7650626Echo exam of head                                 A   0.63   0.26     0.24     0.26     0.24     0.04   0.93   0.91   0.93   0.91  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76510  Ophth us b & quant a                              A   1.55   3.12     3.25     3.12NA   3.25 NA  0.27   4.94   5.07   4.94   5.07  1XXX.00.00.0003000             25.5217 090 99      7.78   7.78   0.29
76510TCOphth us b & quant a                              A   0.00   2.19     2.17     2.19NA   2.17 NA  0.01   2.20   2.18   2.20   2.18  1XXX.00.00.0003000             25.5217 020 99      6.85   6.85   0.03
7651026Ophth us b & quant a                              A   1.55   0.93     1.08     0.93     1.08     0.26   2.74   2.89   2.74   2.89  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
76511  Ophth us quant a only                             A   0.94   1.98     1.95     1.98NA   1.95 NA  0.02   2.94   2.91   2.94   2.91  1XXX.00.00.0003000             25.5217 090 99      4.30   4.30   0.04
76511TCOphth us quant a only                             A   0.00   1.43     1.31     1.43NA   1.31 NA  0.01   1.44   1.32   1.44   1.32  1XXX.00.00.0003000             25.5217 020 99      3.75   3.75   0.03
7651126Ophth us quant a only                             A   0.94   0.55     0.64     0.55     0.64     0.01   1.50   1.59   1.50   1.59  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
76512  Ophth us b w/non-quant a                          A   0.94   1.73     1.69     1.73NA   1.69 NA  0.05   2.72   2.68   2.72   2.68  1XXX.00.00.0003000             25.5217 090 99      4.29   4.29   0.07
76512TCOphth us b w/non-quant a                          A   0.00   1.18     1.06     1.18NA   1.06 NA  0.01   1.19   1.07   1.19   1.07  1XXX.00.00.0003000             25.5217 020 99      3.74   3.74   0.03
7651226Ophth us b w/non-quant a                          A   0.94   0.55     0.63     0.55     0.63     0.04   1.53   1.61   1.53   1.61  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
76513  Echo exam of eye water bath                       A   0.66   1.92     1.95     1.92NA   1.95 NA  0.02   2.60   2.63   2.60   2.63  1XXX.00.00.0003000             25.5217 090 99      4.08   4.08   0.03
76513TCEcho exam of eye water bath                       A   0.00   1.59     1.58     1.59NA   1.58 NA  0.01   1.60   1.59   1.60   1.59  1XXX.00.00.0003000             25.5217 020 99      3.75   3.75   0.02
7651326Echo exam of eye water bath                       A   0.66   0.33     0.37     0.33     0.37     0.01   1.00   1.04   1.00   1.04  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
76514  Echo exam of eye thickness                        A   0.17   0.22     0.25     0.22NA   0.25 NA  0.02   0.41   0.44   0.41   0.44  1XXX.00.00.0002000             25.5217 090 99      0.77   0.77   0.07
76514TCEcho exam of eye thickness                        A   0.00   0.12     0.14     0.12NA   0.14 NA  0.01   0.13   0.15   0.13   0.15  1XXX.00.00.0002000             25.5217 010 99      0.67   0.67   0.06
7651426Echo exam of eye thickness                        A   0.17   0.10     0.11     0.10     0.11     0.01   0.28   0.29   0.28   0.29  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
76516  Echo exam of eye                                  A   0.54   1.57     1.62     1.57NA   1.62 NA  0.02   2.13   2.18   2.13   2.18  1XXX.00.00.0002000             25.5217 090 99      2.73   2.73   0.03
76516TCEcho exam of eye                                  A   0.00   1.26     1.26     1.26NA   1.26 NA  0.01   1.27   1.27   1.27   1.27  1XXX.00.00.0002000             25.5217 010 99      2.42   2.42   0.02
7651626Echo exam of eye                                  A   0.54   0.31     0.36     0.31     0.36     0.01   0.86   0.91   0.86   0.91  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
76519  Echo exam of eye                                  A   0.54   1.72     1.78     1.72NA   1.78 NA  0.04   2.30   2.36   2.30   2.36  1XXX.00.00.0002000             25.5217 090 99      4.07   4.07   0.06
76519TCEcho exam of eye                                  A   0.00   1.40     1.40     1.40NA   1.40 NA  0.01   1.41   1.41   1.41   1.41  1XXX.00.00.0002000             25.5217 010 99      3.75   3.75   0.03
7651926Echo exam of eye                                  A   0.54   0.32     0.38     0.32     0.38     0.03   0.89   0.95   0.89   0.95  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
76529  Echo exam of eye                                  A   0.57   1.57     1.64     1.57NA   1.64 NA  0.04   2.18   2.25   2.18   2.25  1XXX.00.00.0003000             25.5217 090 99      2.76   2.76   0.05
76529TCEcho exam of eye                                  A   0.00   1.23     1.24     1.23NA   1.24 NA  0.01   1.24   1.25   1.24   1.25  1XXX.00.00.0003000             25.5217 010 99      2.42   2.42   0.02
7652926Echo exam of eye                                  A   0.57   0.34     0.40     0.34     0.40     0.03   0.94   1.00   0.94   1.00  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
76536  Us exam of head and neck                          A   0.56   2.91     2.89     2.91NA   2.89 NA  0.04   3.51   3.49   3.51   3.49  1XXX.00.00.0000000             25.5217 090 99      3.99   3.99   0.04
76536TCUs exam of head and neck                          A   0.00   2.68     2.67     2.68NA   2.67 NA  0.01   2.69   2.68   2.69   2.68  1XXX.00.00.0000000             25.5217 010 99      3.76   3.76   0.01
7653626Us exam of head and neck                          A   0.56   0.23     0.22     0.23     0.22     0.03   0.82   0.81   0.82   0.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76604  Us exam chest                                     A   0.55   2.02     1.91     2.02NA   1.91 NA  0.04   2.61   2.50   2.61   2.50  1XXX.00.00.0040000             25.5217 090 88      2.65   2.65   0.04
76604TCUs exam chest                                     A   0.00   1.80     1.71     1.80NA   1.71 NA  0.01   1.81   1.72   1.81   1.72  1XXX.00.00.0040000             25.5217 010 88      2.43   2.43   0.01
7660426Us exam chest                                     A   0.55   0.22     0.20     0.22     0.20     0.03   0.80   0.78   0.80   0.78  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76645  Us exam breast(s)                                 A   0.54   2.26     2.21     2.26NA   2.21 NA  0.05   2.85   2.80   2.85   2.80  1XXX.00.00.0002000             25.5217 090 99      2.65   2.65   0.05
76645TCUs exam breast(s)                                 A   0.00   2.04     2.01     2.04NA   2.01 NA  0.01   2.05   2.02   2.05   2.02  1XXX.00.00.0002000             25.5217 010 99      2.43   2.43   0.01
7664526Us exam breast(s)                                 A   0.54   0.22     0.20     0.22     0.20     0.04   0.80   0.78   0.80   0.78  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
76700  Us exam abdom complete                            A   0.81   3.31     3.17     3.31NA   3.17 NA  0.05   4.17   4.03   4.17   4.03  1XXX.00.00.0040000             25.5217 090 88      4.09   4.09   0.05
76700TCUs exam abdom complete                            A   0.00   2.98     2.86     2.98NA   2.86 NA  0.01   2.99   2.87   2.99   2.87  1XXX.00.00.0040000             25.5217 010 88      3.76   3.76   0.01
7670026Us exam abdom complete                            A   0.81   0.33     0.31     0.33     0.31     0.04   1.18   1.16   1.18   1.16  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76705  Echo exam of abdomen                              A   0.59   2.55     2.44     2.55NA   2.44 NA  0.04   3.18   3.07   3.18   3.07  1XXX.00.00.0040000             25.5217 090 88      4.01   4.01   0.05
76705TCEcho exam of abdomen                              A   0.00   2.30     2.22     2.30NA   2.22 NA  0.01   2.31   2.23   2.31   2.23  1XXX.00.00.0040000             25.5217 010 88      3.76   3.76   0.02
7670526Echo exam of abdomen                              A   0.59   0.25     0.22     0.25     0.22     0.03   0.87   0.84   0.87   0.84  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76770  Us exam abdo back wall comp                       A   0.74   3.18     3.00     3.18NA   3.00 NA  0.05   3.97   3.79   3.97   3.79  1XXX.00.00.0040000             25.5217 090 88      4.07   4.07   0.05
76770TCUs exam abdo back wall comp                       A   0.00   2.87     2.72     2.87NA   2.72 NA  0.01   2.88   2.73   2.88   2.73  1XXX.00.00.0040000             25.5217 010 88      3.76   3.76   0.01
7677026Us exam abdo back wall comp                       A   0.74   0.31     0.28     0.31     0.28     0.04   1.09   1.06   1.09   1.06  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76775  Us exam abdo back wall lim                        A   0.58   2.69     2.46     2.69NA   2.46 NA  0.04   3.31   3.08   3.31   3.08  1XXX.00.00.0040000             25.5217 090 88      4.01   4.01   0.05
76775TCUs exam abdo back wall lim                        A   0.00   2.44     2.24     2.44NA   2.24 NA  0.01   2.45   2.25   2.45   2.25  1XXX.00.00.0040000             25.5217 010 88      3.76   3.76   0.02
7677526Us exam abdo back wall lim                        A   0.58   0.25     0.22     0.25     0.22     0.03   0.86   0.83   0.86   0.83  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76776  Us exam k transpl w/doppler                       A   0.76   3.68     3.55     3.68NA   3.55 NA  0.05   4.49   4.36   4.49   4.36  1XXX.00.00.0040000             25.5217 090 88      0.00   0.00   0.00
76776TCUs exam k transpl w/doppler                       A   0.00   3.37     3.27     3.37NA   3.27 NA  0.01   3.38   3.28   3.38   3.28  1XXX.00.00.0040000             25.5217 010 88      0.00   0.00   0.00
7677626Us exam k transpl w/doppler                       A   0.76   0.31     0.28     0.31     0.28     0.04   1.11   1.08   1.11   1.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76800  Us exam spinal canal                              A   1.13   2.77     2.92     2.77NA   2.92 NA  0.05   3.95   4.10   3.95   4.10  1XXX.00.00.0000000             25.5217 090 99      4.21   4.21   0.06
76800TCUs exam spinal canal                              A   0.00   2.32     2.42     2.32NA   2.42 NA  0.01   2.33   2.43   2.33   2.43  1XXX.00.00.0000000             25.5217 010 99      3.76   3.76   0.02
7680026Us exam spinal canal                              A   1.13   0.45     0.50     0.45     0.50     0.04   1.62   1.67   1.62   1.67  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76801  Ob us < 14 wks single fetus                       A   0.99   2.83     2.63     2.83NA   2.63 NA  0.04   3.86   3.66   3.86   3.66  1XXX.00.00.0000000             25.5217 010 99      4.18   4.18   0.05
76801TCOb us < 14 wks single fetus                       A   0.00   2.41     2.22     2.41NA   2.22 NA  0.01   2.42   2.23   2.42   2.23  1XXX.00.00.0000000             25.5217 010 99      3.76   3.76   0.02
7680126Ob us < 14 wks single fetus                       A   0.99   0.42     0.41     0.42     0.41     0.03   1.44   1.43   1.44   1.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76802  Ob us < 14 wks addl fetus                         A   0.83   1.20     1.09     1.20NA   1.09 NA  0.04   2.07   1.96   2.07   1.96  1ZZZ.00.00.0000000             25.5217 010 99      2.76   2.76   0.06
76802TCOb us < 14 wks addl fetus                         A   0.00   0.85     0.74     0.85NA   0.74 NA  0.01   0.86   0.75   0.86   0.75  1ZZZ.00.00.0000000             25.5217 010 99      2.41   2.41   0.03
7680226Ob us < 14 wks addl fetus                         A   0.83   0.35     0.35     0.35     0.35     0.03   1.21   1.21   1.21   1.21  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76805  Ob us >/= 14 wks sngl fetus                       A   0.99   3.39     3.24     3.39NA   3.24 NA  0.04   4.42   4.27   4.42   4.27  1XXX.00.00.0000000             25.5217 090 99      4.18   4.18   0.04
76805TCOb us >/= 14 wks sngl fetus                       A   0.00   2.97     2.82     2.97NA   2.82 NA  0.01   2.98   2.83   2.98   2.83  1XXX.00.00.0000000             25.5217 010 99      3.76   3.76   0.01
7680526Ob us >/= 14 wks sngl fetus                       A   0.99   0.42     0.42     0.42     0.42     0.03   1.44   1.44   1.44   1.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76810  Ob us >/= 14 wks addl fetus                       A   0.98   1.88     1.81     1.88NA   1.81 NA  0.04   2.90   2.83   2.90   2.83  1ZZZ.00.00.0000000             25.5217 090 99      4.17   4.17   0.06
76810TCOb us >/= 14 wks addl fetus                       A   0.00   1.46     1.39     1.46NA   1.39 NA  0.01   1.47   1.40   1.47   1.40  1ZZZ.00.00.0000000             25.5217 010 99      3.75   3.75   0.03
7681026Ob us >/= 14 wks addl fetus                       A   0.98   0.42     0.42     0.42     0.42     0.03   1.43   1.43   1.43   1.43  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76811  Ob us detailed sngl fetus                         A   1.90   3.76     3.45     3.76NA   3.45 NA  0.06   5.72   5.41   5.72   5.41  1XXX.00.00.0000000             25.5217 010 99      6.78   6.78   0.07
76811TCOb us detailed sngl fetus                         A   0.00   2.95     2.58     2.95NA   2.58 NA  0.01   2.96   2.59   2.96   2.59  1XXX.00.00.0000000             25.5217 010 99      5.97   5.97   0.02
7681126Ob us detailed sngl fetus                         A   1.90   0.81     0.87     0.81     0.87     0.05   2.76   2.82   2.76   2.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76812  Ob us detailed addl fetus                         A   1.78   4.24     4.34     4.24NA   4.34 NA  0.06   6.08   6.18   6.08   6.18  1ZZZ.00.00.0000000             25.5217 010 99      3.19   3.19   0.06
76812TCOb us detailed addl fetus                         A   0.00   3.48     3.53     3.48NA   3.53 NA  0.01   3.49   3.54   3.49   3.54  1ZZZ.00.00.0000000             25.5217 010 99      2.43   2.43   0.01
7681226Ob us detailed addl fetus                         A   1.78   0.76     0.81     0.76     0.81     0.05   2.59   2.64   2.59   2.64  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76813  Ob us nuchal meas 1 gest                          A   1.18   2.53     2.41     2.53NA   2.41 NA  0.05   3.76   3.64   3.76   3.64  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
76813TCOb us nuchal meas 1 gest                          A   0.00   2.04     1.87     2.04NA   1.87 NA  0.01   2.05   1.88   2.05   1.88  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7681326Ob us nuchal meas 1 gest                          A   1.18   0.49     0.54     0.49     0.54     0.04   1.71   1.76   1.71   1.76  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76814  Ob us nuchal meas add-on                          A   0.99   1.38     1.35     1.38NA   1.35 NA  0.04   2.41   2.38   2.41   2.38  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
76814TCOb us nuchal meas add-on                          A   0.00   0.96     0.89     0.96NA   0.89 NA  0.01   0.97   0.90   0.97   0.90  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7681426Ob us nuchal meas add-on                          A   0.99   0.42     0.46     0.42     0.46     0.03   1.44   1.48   1.44   1.48  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76815  Ob us limited fetus(s)                            A   0.65   2.04     1.93     2.04NA   1.93 NA  0.02   2.71   2.60   2.71   2.60  1XXX.00.00.0000000             25.5217 090 99      2.70   2.70   0.02
76815TCOb us limited fetus(s)                            A   0.00   1.77     1.66     1.77NA   1.66 NA  0.01   1.78   1.67   1.78   1.67  1XXX.00.00.0000000             25.5217 010 99      2.43   2.43   0.01
7681526Ob us limited fetus(s)                            A   0.65   0.27     0.27     0.27     0.27     0.01   0.93   0.93   0.93   0.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76816  Ob us follow-up per fetus                         A   0.85   2.58     2.56     2.58NA   2.56 NA  0.04   3.47   3.45   3.47   3.45  1XXX.00.00.0000000             25.5217 090 99      2.79   2.79   0.04
76816TCOb us follow-up per fetus                         A   0.00   2.22     2.18     2.22NA   2.18 NA  0.01   2.23   2.19   2.23   2.19  1XXX.00.00.0000000             25.5217 010 99      2.43   2.43   0.01
7681626Ob us follow-up per fetus                         A   0.85   0.36     0.38     0.36     0.38     0.03   1.24   1.26   1.24   1.26  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76817  Transvaginal us obstetric                         A   0.75   2.27     2.16     2.27NA   2.16 NA  0.04   3.06   2.95   3.06   2.95  1XXX.00.00.0000000             25.5217 010 99      2.74   2.74   0.04
76817TCTransvaginal us obstetric                         A   0.00   1.96     1.84     1.96NA   1.84 NA  0.01   1.97   1.85   1.97   1.85  1XXX.00.00.0000000             25.5217 010 99      2.43   2.43   0.01
7681726Transvaginal us obstetric                         A   0.75   0.31     0.32     0.31     0.32     0.03   1.09   1.10   1.09   1.10  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76818  Fetal biophys profile w/nst                       A   1.05   2.54     2.46     2.54NA   2.46 NA  0.04   3.63   3.55   3.63   3.55  1XXX.00.00.0000000             25.5217 090 99      4.20   4.20   0.05
76818TCFetal biophys profile w/nst                       A   0.00   2.09     1.98     2.09NA   1.98 NA  0.01   2.10   1.99   2.10   1.99  1XXX.00.00.0000000             25.5217 010 99      3.75   3.75   0.02
7681826Fetal biophys profile w/nst                       A   1.05   0.45     0.48     0.45     0.48     0.03   1.53   1.56   1.53   1.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76819  Fetal biophys profil w/o nst                      A   0.77   1.92     1.77     1.92NA   1.77 NA  0.04   2.73   2.58   2.73   2.58  1XXX.00.00.0000000             25.5217 090 99      4.08   4.08   0.05
76819TCFetal biophys profil w/o nst                      A   0.00   1.59     1.43     1.59NA   1.43 NA  0.01   1.60   1.44   1.60   1.44  1XXX.00.00.0000000             25.5217 010 99      3.75   3.75   0.02
7681926Fetal biophys profil w/o nst                      A   0.77   0.33     0.34     0.33     0.34     0.03   1.13   1.14   1.13   1.14  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76820  Umbilical artery echo                             A   0.50   0.86     0.67     0.86NA   0.67 NA  0.02   1.38   1.19   1.38   1.19  1XXX.00.00.0000000             25.5217 090 99      2.61   2.61   0.05
76820TCUmbilical artery echo                             A   0.00   0.65     0.44     0.65NA   0.44 NA  0.01   0.66   0.45   0.66   0.45  1XXX.00.00.0000000             25.5217 010 99      2.40   2.40   0.04
7682026Umbilical artery echo                             A   0.50   0.21     0.23     0.21     0.23     0.01   0.72   0.74   0.72   0.74  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76821  Middle cerebral artery echo                       A   0.70   2.15     2.03     2.15NA   2.03 NA  0.04   2.89   2.77   2.89   2.77  1XXX.00.00.0000000             25.5217 090 99      2.73   2.73   0.04
76821TCMiddle cerebral artery echo                       A   0.00   1.85     1.71     1.85NA   1.71 NA  0.01   1.86   1.72   1.86   1.72  1XXX.00.00.0000000             25.5217 010 99      2.43   2.43   0.01
7682126Middle cerebral artery echo                       A   0.70   0.30     0.32     0.30     0.32     0.03   1.03   1.05   1.03   1.05  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76825  Echo exam of fetal heart                          A   1.67   4.71     4.66     4.71NA   4.66 NA  0.05   6.43   6.38   6.43   6.38  1XXX.00.00.0000000             25.5217 090 99     22.67  22.67   0.09
76825TCEcho exam of fetal heart                          A   0.00   4.01     3.93     4.01NA   3.93 NA  0.01   4.02   3.94   4.02   3.94  1XXX.00.00.0000000             25.5217 010 99     21.97  21.97   0.05
7682526Echo exam of fetal heart                          A   1.67   0.70     0.73     0.70     0.73     0.04   2.41   2.44   2.41   2.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76826  Echo exam of fetal heart                          A   0.83   2.84     2.92     2.84NA   2.92 NA  0.04   3.71   3.79   3.71   3.79  1XXX.00.00.0000000             25.5217 090 99     16.04  16.04   0.09
76826TCEcho exam of fetal heart                          A   0.00   2.50     2.56     2.50NA   2.56 NA  0.01   2.51   2.57   2.51   2.57  1XXX.00.00.0000000             25.5217 010 99     15.70  15.70   0.06
7682626Echo exam of fetal heart                          A   0.83   0.34     0.36     0.34     0.36     0.03   1.20   1.22   1.20   1.22  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76827  Echo exam of fetal heart                          A   0.58   1.37     1.17     1.37NA   1.17 NA  0.02   1.97   1.77   1.97   1.77  1XXX.00.00.0000000             25.5217 090 99      2.66   2.66   0.03
76827TCEcho exam of fetal heart                          A   0.00   1.13     0.92     1.13NA   0.92 NA  0.01   1.14   0.93   1.14   0.93  1XXX.00.00.0000000             25.5217 010 99      2.42   2.42   0.02
7682726Echo exam of fetal heart                          A   0.58   0.24     0.25     0.24     0.25     0.01   0.83   0.84   0.83   0.84  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76828  Echo exam of fetal heart                          A   0.56   0.87     0.73     0.87NA   0.73 NA  0.02   1.45   1.31   1.45   1.31  1XXX.00.00.0000000             25.5217 090 99      2.64   2.64   0.05
76828TCEcho exam of fetal heart                          A   0.00   0.63     0.48     0.63NA   0.48 NA  0.01   0.64   0.49   0.64   0.49  1XXX.00.00.0000000             25.5217 010 99      2.40   2.40   0.04
7682826Echo exam of fetal heart                          A   0.56   0.24     0.25     0.24     0.25     0.01   0.81   0.82   0.81   0.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76830  Transvaginal us non-ob                            A   0.69   2.98     2.90     2.98NA   2.90 NA  0.04   3.71   3.63   3.71   3.63  1XXX.00.00.0000000             25.5217 090 99      4.05   4.05   0.04
76830TCTransvaginal us non-ob                            A   0.00   2.69     2.62     2.69NA   2.62 NA  0.01   2.70   2.63   2.70   2.63  1XXX.00.00.0000000             25.5217 010 99      3.76   3.76   0.01
7683026Transvaginal us non-ob                            A   0.69   0.29     0.28     0.29     0.28     0.03   1.01   1.00   1.01   1.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76831  Echo exam uterus                                  A   0.72   2.96     2.91     2.96NA   2.91 NA  0.04   3.72   3.67   3.72   3.67  1XXX.00.00.0040000             25.5217 090 88      6.27   6.27   0.05
76831TCEcho exam uterus                                  A   0.00   2.66     2.58     2.66NA   2.58 NA  0.01   2.67   2.59   2.67   2.59  1XXX.00.00.0040000             25.5217 030 88      5.97   5.97   0.02
7683126Echo exam uterus                                  A   0.72   0.30     0.33     0.30     0.33     0.03   1.05   1.08   1.05   1.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76856  Us exam pelvic complete                           A   0.69   2.97     2.86     2.97NA   2.86 NA  0.04   3.70   3.59   3.70   3.59  1XXX.00.00.0040000             25.5217 090 88      4.05   4.05   0.04
76856TCUs exam pelvic complete                           A   0.00   2.68     2.59     2.68NA   2.59 NA  0.01   2.69   2.60   2.69   2.60  1XXX.00.00.0040000             25.5217 010 88      3.76   3.76   0.01
7685626Us exam pelvic complete                           A   0.69   0.29     0.27     0.29     0.27     0.03   1.01   0.99   1.01   0.99  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76857  Us exam pelvic limited                            A   0.38   2.59     2.34     2.59NA   2.34 NA  0.04   3.01   2.76   3.01   2.76  1XXX.00.00.0040000             25.5217 090 88      2.60   2.60   0.04
76857TCUs exam pelvic limited                            A   0.00   2.42     2.19     2.42NA   2.19 NA  0.01   2.43   2.20   2.43   2.20  1XXX.00.00.0040000             25.5217 010 88      2.43   2.43   0.01
7685726Us exam pelvic limited                            A   0.38   0.17     0.15     0.17     0.15     0.03   0.58   0.56   0.58   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76870  Us exam scrotum                                   A   0.64   2.99     2.86     2.99NA   2.86 NA  0.05   3.68   3.55   3.68   3.55  1XXX.00.00.0040000             25.5217 090 88      4.03   4.03   0.05
76870TCUs exam scrotum                                   A   0.00   2.72     2.62     2.72NA   2.62 NA  0.01   2.73   2.63   2.73   2.63  1XXX.00.00.0040000             25.5217 010 88      3.76   3.76   0.01
7687026Us exam scrotum                                   A   0.64   0.27     0.24     0.27     0.24     0.04   0.95   0.92   0.95   0.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76872  Us transrectal                                    A   0.69   3.43     3.06     3.43NA   3.06 NA  0.05   4.17   3.80   4.17   3.80  1XXX.00.00.0000000             25.5217 090 99      4.07   4.07   0.05
76872TCUs transrectal                                    A   0.00   3.12     2.79     3.12NA   2.79 NA  0.01   3.13   2.80   3.13   2.80  1XXX.00.00.0000000             25.5217 010 99      3.76   3.76   0.01
7687226Us transrectal                                    A   0.69   0.31     0.27     0.31     0.27     0.04   1.04   1.00   1.04   1.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76873  Echograp trans r pros study                       A   1.55   3.65     3.42     3.65NA   3.42 NA  0.09   5.29   5.06   5.29   5.06  1XXX.00.00.0099999             25.5217 090 99      4.43   4.43   0.09
76873TCEchograp trans r pros study                       A   0.00   2.98     2.76     2.98NA   2.76 NA  0.01   2.99   2.77   2.99   2.77  1XXX.00.00.0099999             25.5217 020 99      3.76   3.76   0.01
7687326Echograp trans r pros study                       A   1.55   0.67     0.66     0.67     0.66     0.08   2.30   2.29   2.30   2.29  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
76881  Us xtr non-vasc complete                          A   0.59   2.76     2.76     2.76NA   2.76 NA  0.05   3.40   3.40   3.40   3.40  1XXX.00.00.0000900             25.5217 090 99      3.98   3.98   0.05
76881TCUs xtr non-vasc complete                          A   0.00   2.54     2.54     2.54NA   2.54 NA  0.01   2.55   2.55   2.55   2.55  1XXX.00.00.0000900             25.5217 010 99      3.76   3.76   0.01
7688126Us xtr non-vasc complete                          A   0.59   0.22     0.22     0.22     0.22     0.04   0.85   0.85   0.85   0.85  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
76882  Us xtr non-vasc lmtd                              A   0.41   0.44     0.44     0.44NA   0.44 NA  0.04   0.89   0.89   0.89   0.89  1XXX.00.00.0000900             25.5217 090 99      2.51   2.51   0.11
76882TCUs xtr non-vasc lmtd                              A   0.00   0.29     0.29     0.29NA   0.29 NA  0.01   0.30   0.30   0.30   0.30  1XXX.00.00.0000900             25.5217 010 99      2.36   2.36   0.08
7688226Us xtr non-vasc lmtd                              A   0.41   0.15     0.15     0.15     0.15     0.03   0.59   0.59   0.59   0.59  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
76885  Us exam infant hips dynamic                       A   0.74   3.52     3.50     3.52NA   3.50 NA  0.05   4.31   4.29   4.31   4.29  1XXX.00.00.0000000             25.5217 090 99      2.74   2.74   0.05
76885TCUs exam infant hips dynamic                       A   0.00   3.21     3.21     3.21NA   3.21 NA  0.01   3.22   3.22   3.22   3.22  1XXX.00.00.0000000             25.5217 010 99      2.43   2.43   0.01
7688526Us exam infant hips dynamic                       A   0.74   0.31     0.29     0.31     0.29     0.04   1.09   1.07   1.09   1.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76886  Us exam infant hips static                        A   0.62   2.78     3.04     2.78NA   3.04 NA  0.02   3.42   3.68   3.42   3.68  1XXX.00.00.0000000             25.5217 090 99      2.71   2.71   0.02
76886TCUs exam infant hips static                        A   0.00   2.50     2.74     2.50NA   2.74 NA  0.01   2.51   2.75   2.51   2.75  1XXX.00.00.0000000             25.5217 010 99      2.43   2.43   0.01
7688626Us exam infant hips static                        A   0.62   0.28     0.30     0.28     0.30     0.01   0.91   0.93   0.91   0.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76930  Echo guide cardiocentesis                         A   0.67   1.99     1.64     1.99NA   1.64 NA  0.02   2.68   2.33   2.68   2.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76930TCEcho guide cardiocentesis                         A   0.00   1.67     1.38     1.67NA   1.38 NA  0.01   1.68   1.39   1.68   1.39  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7693026Echo guide cardiocentesis                         A   0.67   0.32     0.26     0.32     0.26     0.01   1.00   0.94   1.00   0.94  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76932  Echo guide for heart biopsy                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76932TCEcho guide for heart biopsy                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7693226Echo guide for heart biopsy                       A   0.67   0.33     0.26     0.33     0.26     0.04   1.04   0.97   1.04   0.97  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76936  Echo guide for artery repair                      A   1.99   6.98     6.29     6.98NA   6.29 NA  0.24   9.21   8.52   9.21   8.52  1XXX.00.00.0000000             25.5217 090 99      4.97   4.97   0.24
76936TCEcho guide for artery repair                      A   0.00   6.18     5.58     6.18NA   5.58 NA  0.01   6.19   5.59   6.19   5.59  1XXX.00.00.0000000             25.5217 030 99      4.17   4.17   0.01
7693626Echo guide for artery repair                      A   1.99   0.80     0.71     0.80     0.71     0.23   3.02   2.93   3.02   2.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76937  Us guide vascular access                          A   0.30   0.70     0.67     0.70NA   0.67 NA  0.04   1.04   1.01   1.04   1.01  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76937TCUs guide vascular access                          A   0.00   0.58     0.56     0.58NA   0.56 NA  0.01   0.59   0.57   0.59   0.57  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7693726Us guide vascular access                          A   0.30   0.12     0.11     0.12     0.11     0.03   0.45   0.44   0.45   0.44  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76940  Us guide tissue ablation                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76940TCUs guide tissue ablation                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7694026Us guide tissue ablation                          A   2.00   0.82     0.80     0.82     0.80     0.29   3.11   3.09   3.11   3.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76941  Echo guide for transfusion                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76941TCEcho guide for transfusion                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7694126Echo guide for transfusion                        A   1.34   0.58     0.62     0.58     0.62     0.11   2.03   2.07   2.03   2.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76942  Echo guide for biopsy                             A   0.67   5.13     4.98     5.13NA   4.98 NA  0.05   5.85   5.70   5.85   5.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76942TCEcho guide for biopsy                             A   0.00   4.85     4.72     4.85NA   4.72 NA  0.01   4.86   4.73   4.86   4.73  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7694226Echo guide for biopsy                             A   0.67   0.28     0.26     0.28     0.26     0.04   0.99   0.97   0.99   0.97  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76945  Echo guide villus sampling                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76945TCEcho guide villus sampling                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7694526Echo guide villus sampling                        A   0.67   0.29     0.31     0.29     0.31     0.04   1.00   1.02   1.00   1.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76946  Echo guide for amniocentesis                      A   0.38   0.72     0.52     0.72NA   0.52 NA  0.02   1.12   0.92   1.12   0.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76946TCEcho guide for amniocentesis                      A   0.00   0.56     0.35     0.56NA   0.35 NA  0.01   0.57   0.36   0.57   0.36  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7694626Echo guide for amniocentesis                      A   0.38   0.16     0.17     0.16     0.17     0.01   0.55   0.56   0.55   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76948  Echo guide ova aspiration                         A   0.38   0.72     0.54     0.72NA   0.54 NA  0.04   1.14   0.96   1.14   0.96  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76948TCEcho guide ova aspiration                         A   0.00   0.56     0.36     0.56NA   0.36 NA  0.01   0.57   0.37   0.57   0.37  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7694826Echo guide ova aspiration                         A   0.38   0.16     0.18     0.16     0.18     0.03   0.57   0.59   0.57   0.59  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76950  Echo guidance radiotherapy                        A   0.58   1.43     1.29     1.43NA   1.29 NA  0.04   2.05   1.91   2.05   1.91  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76950TCEcho guidance radiotherapy                        A   0.00   1.18     1.03     1.18NA   1.03 NA  0.01   1.19   1.04   1.19   1.04  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7695026Echo guidance radiotherapy                        A   0.58   0.25     0.26     0.25     0.26     0.03   0.86   0.87   0.86   0.87  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76965  Echo guidance radiotherapy                        A   1.34   2.07     1.20     2.07NA   1.20 NA  0.09   3.50   2.63   3.50   2.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76965TCEcho guidance radiotherapy                        A   0.00   1.48     0.64     1.48NA   0.64 NA  0.01   1.49   0.65   1.49   0.65  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7696526Echo guidance radiotherapy                        A   1.34   0.59     0.56     0.59     0.56     0.08   2.01   1.98   2.01   1.98  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76970  Ultrasound exam follow-up                         A   0.40   2.40     2.57     2.40NA   2.57 NA  0.05   2.85   3.02   2.85   3.02  1XXX.00.00.0000000             25.5217 090 99      2.59   2.59   0.05
76970TCUltrasound exam follow-up                         A   0.00   2.24     2.40     2.24NA   2.40 NA  0.01   2.25   2.41   2.25   2.41  1XXX.00.00.0000000             25.5217 010 99      2.43   2.43   0.01
7697026Ultrasound exam follow-up                         A   0.40   0.16     0.17     0.16     0.17     0.04   0.60   0.61   0.60   0.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76975  GI endoscopic ultrasound                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      6.37   6.37   0.09
76975TCGI endoscopic ultrasound                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      5.98   5.98   0.01
7697526GI endoscopic ultrasound                          A   0.81   0.39     0.40     0.39     0.40     0.08   1.28   1.29   1.28   1.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76977  Us bone density measure                           A   0.05   0.24     0.14     0.24NA   0.14 NA  0.02   0.31   0.21   0.31   0.21  1XXX.00.00.0000000             25.5217 090 99      1.75   1.75   0.09
76977TCUs bone density measure                           A   0.00   0.22     0.12     0.22NA   0.12 NA  0.01   0.23   0.13   0.23   0.13  1XXX.00.00.0000000             25.5217 010 99      1.73   1.73   0.08
7697726Us bone density measure                           A   0.05   0.02     0.02     0.02     0.02     0.01   0.08   0.08   0.08   0.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76998  Us guide intraop                                  C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76998TCUs guide intraop                                  C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
7699826Us guide intraop                                  A   1.20   0.47     0.47     0.47     0.47     0.26   1.93   1.93   1.93   1.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76999  Echo examination procedure                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
76999TCEcho examination procedure                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7699926Echo examination procedure                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77001  Fluoroguide for vein device                       A   0.38   2.97     3.00     2.97NA   3.00 NA  0.04   3.39   3.42   3.39   3.42  1ZZZ.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77001TCFluoroguide for vein device                       A   0.00   2.81     2.86     2.81NA   2.86 NA  0.01   2.82   2.87   2.82   2.87  1ZZZ.00.00.0000900             25.5217 030 99      0.00   0.00   0.00
7700126Fluoroguide for vein device                       A   0.38   0.16     0.14     0.16     0.14     0.03   0.57   0.55   0.57   0.55  1ZZZ.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77002  Needle localization by xray                       A   0.54   1.65     1.66     1.65NA   1.66 NA  0.04   2.23   2.24   2.23   2.24  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77002TCNeedle localization by xray                       A   0.00   1.41     1.41     1.41NA   1.41 NA  0.01   1.42   1.42   1.42   1.42  1XXX.00.00.0000900             25.5217 030 99      0.00   0.00   0.00
7700226Needle localization by xray                       A   0.54   0.24     0.25     0.24     0.25     0.03   0.81   0.82   0.81   0.82  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77003  Fluoroguide for spine inject                      A   0.60   1.20     1.25     1.20NA   1.25 NA  0.04   1.84   1.89   1.84   1.89  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
77003TCFluoroguide for spine inject                      A   0.00   0.96     0.96     0.96NA   0.96 NA  0.01   0.97   0.97   0.97   0.97  1XXX.00.00.0099999             25.5217 030 99      0.00   0.00   0.00
7700326Fluoroguide for spine inject                      A   0.60   0.24     0.29     0.24     0.29     0.03   0.87   0.92   0.87   0.92  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
77011  Ct scan for localization                          A   1.21  13.03     5.40    13.03NA   5.40 NA  0.05  14.29   6.66  14.29   6.66  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77011TCCt scan for localization                          A   0.00  12.49     4.85    12.49NA   4.85 NA  0.01  12.50   4.86  12.50   4.86  1XXX.00.00.0000900             25.5217 030 99      0.00   0.00   0.00
7701126Ct scan for localization                          A   1.21   0.54     0.55     0.54     0.55     0.04   1.79   1.80   1.79   1.80  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77012  Ct scan for needle biopsy                         A   1.16   3.63     2.47     3.63NA   2.47 NA  0.05   4.84   3.68   4.84   3.68  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77012TCCt scan for needle biopsy                         A   0.00   3.14     2.04     3.14NA   2.04 NA  0.01   3.15   2.05   3.15   2.05  1XXX.00.00.0000900             25.5217 030 99      0.00   0.00   0.00
7701226Ct scan for needle biopsy                         A   1.16   0.49     0.43     0.49     0.43     0.04   1.69   1.63   1.69   1.63  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77013  Ct guide for tissue ablation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77013TCCt guide for tissue ablation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7701326Ct guide for tissue ablation                      A   3.99   1.66     1.46     1.66     1.46     0.37   6.02   5.82   6.02   5.82  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77014  Ct scan for therapy guide                         A   0.85   4.78     4.55     4.78NA   4.55 NA  0.05   5.68   5.45   5.68   5.45  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77014TCCt scan for therapy guide                         A   0.00   4.41     4.17     4.41NA   4.17 NA  0.01   4.42   4.18   4.42   4.18  1XXX.00.00.0000900             25.5217 020 99      0.00   0.00   0.00
7701426Ct scan for therapy guide                         A   0.85   0.37     0.38     0.37     0.38     0.04   1.26   1.27   1.26   1.27  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77021  Mr guidance for needle place                      A   1.50  11.20     9.82    11.20NA   9.82 NA  0.13  12.83  11.45  12.83  11.45  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77021TCMr guidance for needle place                      A   0.00  10.58     9.26    10.58NA   9.26 NA  0.01  10.59   9.27  10.59   9.27  1XXX.00.00.0000900             25.5217 030 99      0.00   0.00   0.00
7702126Mr guidance for needle place                      A   1.50   0.62     0.56     0.62     0.56     0.12   2.24   2.18   2.24   2.18  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77022  Mri for tissue ablation                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77022TCMri for tissue ablation                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7702226Mri for tissue ablation                           A   4.24   1.74     1.65     1.74     1.65     0.38   6.36   6.27   6.36   6.27  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77031  Stereotact guide for brst bx                      A   1.59   3.05     2.02     3.05NA   2.02 NA  0.13   4.77   3.74   4.77   3.74  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77031TCStereotact guide for brst bx                      A   0.00   2.40     1.41     2.40NA   1.41 NA  0.01   2.41   1.42   2.41   1.42  1XXX.00.00.0000900             25.5217 030 99      0.00   0.00   0.00
7703126Stereotact guide for brst bx                      A   1.59   0.65     0.61     0.65     0.61     0.12   2.36   2.32   2.36   2.32  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77032  Guidance for needle breast                        A   0.56   1.05     0.87     1.05NA   0.87 NA  0.04   1.65   1.47   1.65   1.47  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77032TCGuidance for needle breast                        A   0.00   0.82     0.66     0.82NA   0.66 NA  0.01   0.83   0.67   0.83   0.67  1XXX.00.00.0000900             25.5217 030 99      0.00   0.00   0.00
7703226Guidance for needle breast                        A   0.56   0.23     0.21     0.23     0.21     0.03   0.82   0.80   0.82   0.80  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77051  Computer dx mammogram add-on                      A   0.06   0.26     0.20     0.26NA   0.20 NA  0.02   0.34   0.28   0.34   0.28  1ZZZ.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77051TCComputer dx mammogram add-on                      A   0.00   0.24     0.18     0.24NA   0.18 NA  0.01   0.25   0.19   0.25   0.19  1ZZZ.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
7705126Computer dx mammogram add-on                      A   0.06   0.02     0.02     0.02     0.02     0.01   0.09   0.09   0.09   0.09  1ZZZ.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77052  Comp screen mammogram add-on                      A   0.06   0.26     0.20     0.26NA   0.20 NA  0.02   0.34   0.28   0.34   0.28  1ZZZ.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77052TCComp screen mammogram add-on                      A   0.00   0.24     0.18     0.24NA   0.18 NA  0.01   0.25   0.19   0.25   0.19  1ZZZ.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
7705226Comp screen mammogram add-on                      A   0.06   0.02     0.02     0.02     0.02     0.01   0.09   0.09   0.09   0.09  1ZZZ.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77053  X-ray of mammary duct                             A   0.36   1.62     1.27     1.62NA   1.27 NA  0.02   2.00   1.65   2.00   1.65  1XXX.00.00.0000900             25.5217 090 99      9.10   9.10   0.07
77053TCX-ray of mammary duct                             A   0.00   1.47     1.14     1.47NA   1.14 NA  0.01   1.48   1.15   1.48   1.15  1XXX.00.00.0000900             25.5217 030 99      8.95   8.95   0.06
7705326X-ray of mammary duct                             A   0.36   0.15     0.13     0.15     0.13     0.01   0.52   0.50   0.52   0.50  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77054  X-ray of mammary ducts                            A   0.45   2.23     1.75     2.23NA   1.75 NA  0.04   2.72   2.24   2.72   2.24  1XXX.00.00.0000900             25.5217 090 99      9.16   9.16   0.07
77054TCX-ray of mammary ducts                            A   0.00   2.04     1.58     2.04NA   1.58 NA  0.01   2.05   1.59   2.05   1.59  1XXX.00.00.0000900             25.5217 030 99      8.97   8.97   0.04
7705426X-ray of mammary ducts                            A   0.45   0.19     0.17     0.19     0.17     0.03   0.67   0.65   0.67   0.65  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77055  Mammogram one breast                              A   0.70   1.81     1.70     1.81NA   1.70 NA  0.05   2.56   2.45   2.56   2.45  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77055TCMammogram one breast                              A   0.00   1.52     1.44     1.52NA   1.44 NA  0.01   1.53   1.45   1.53   1.45  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
7705526Mammogram one breast                              A   0.70   0.29     0.26     0.29     0.26     0.04   1.03   1.00   1.03   1.00  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77056  Mammogram both breasts                            A   0.87   2.34     2.23     2.34NA   2.23 NA  0.06   3.27   3.16   3.27   3.16  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77056TCMammogram both breasts                            A   0.00   1.98     1.90     1.98NA   1.90 NA  0.01   1.99   1.91   1.99   1.91  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
7705626Mammogram both breasts                            A   0.87   0.36     0.33     0.36     0.33     0.05   1.28   1.25   1.28   1.25  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77057  Mammogram screening                               A   0.70   1.65     1.51     1.65NA   1.51 NA  0.05   2.40   2.26   2.40   2.26  1XXX.00.00.0002900             25.5217 090 99      0.00   0.00   0.00
77057TCMammogram screening                               A   0.00   1.36     1.24     1.36NA   1.24 NA  0.01   1.37   1.25   1.37   1.25  1XXX.00.00.0002900             25.5217 090 99      0.00   0.00   0.00
7705726Mammogram screening                               A   0.70   0.29     0.27     0.29     0.27     0.04   1.03   1.01   1.03   1.01  1XXX.00.00.0002900             25.5217 090 99      0.00   0.00   0.00
77058  Mri one breast                                    A   1.63  20.67    16.10    20.67NA  16.10 NA  0.11  22.41  17.84  22.41  17.84  1XXX.00.00.0040900             25.5217 090 88     21.57  21.57   0.11
77058TCMri one breast                                    A   0.00  20.00    15.49    20.00NA  15.49 NA  0.01  20.01  15.50  20.01  15.50  1XXX.00.00.0040900             25.5217 020 88     20.90  20.90   0.01
7705826Mri one breast                                    A   1.63   0.67     0.61     0.67     0.61     0.10   2.40   2.34   2.40   2.34  1XXX.00.00.0000900             25.5217 090 99      0.00   0.00   0.00
77059  Mri both breasts                                  A   1.63  21.52    15.99    21.52NA  15.99 NA  0.11  23.26  17.73  23.26  17.73  1XXX.00.00.0042900             25.5217 090 88     21.57  21.57   0.11
77059TCMri both breasts                                  A   0.00  20.85    15.39    20.85NA  15.39 NA  0.01  20.86  15.40  20.86  15.40  1XXX.00.00.0042900             25.5217 020 88     20.90  20.90   0.01
7705926Mri both breasts                                  A   1.63   0.67     0.60     0.67     0.60     0.10   2.40   2.33   2.40   2.33  1XXX.00.00.0002900             25.5217 090 99      0.00   0.00   0.00
77071  X-ray stress view                                 A   0.41   0.90     1.03     0.90     1.03     0.07   1.38   1.51   1.38   1.51  2XXX.00.00.0003000             25.5217 030 99      0.00   0.00   0.00
77072  X-rays for bone age                               A   0.19   0.49     0.47     0.49NA   0.47 NA  0.02   0.70   0.68   0.70   0.68  1XXX.00.00.0000000             25.5217 090 99      1.80   1.80   0.05
77072TCX-rays for bone age                               A   0.00   0.41     0.39     0.41NA   0.39 NA  0.01   0.42   0.40   0.42   0.40  1XXX.00.00.0000000             25.5217 010 99      1.72   1.72   0.04
7707226X-rays for bone age                               A   0.19   0.08     0.08     0.08     0.08     0.01   0.28   0.28   0.28   0.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77073  X-rays bone length studies                        A   0.27   0.84     0.82     0.84NA   0.82 NA  0.05   1.16   1.14   1.16   1.14  1XXX.00.00.0000000             25.5217 090 99      1.87   1.87   0.06
77073TCX-rays bone length studies                        A   0.00   0.71     0.68     0.71NA   0.68 NA  0.01   0.72   0.69   0.72   0.69  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7707326X-rays bone length studies                        A   0.27   0.13     0.14     0.13     0.14     0.04   0.44   0.45   0.44   0.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77074  X-rays bone survey limited                        A   0.45   1.59     1.49     1.59NA   1.49 NA  0.04   2.08   1.98   2.08   1.98  1XXX.00.00.0000000             25.5217 090 99      3.14   3.14   0.05
77074TCX-rays bone survey limited                        A   0.00   1.40     1.32     1.40NA   1.32 NA  0.01   1.41   1.33   1.41   1.33  1XXX.00.00.0000000             25.5217 010 99      2.95   2.95   0.02
7707426X-rays bone survey limited                        A   0.45   0.19     0.17     0.19     0.17     0.03   0.67   0.65   0.67   0.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77075  X-rays bone survey complete                       A   0.54   2.48     2.37     2.48NA   2.37 NA  0.04   3.06   2.95   3.06   2.95  1XXX.00.00.0000000             25.5217 090 99      3.19   3.19   0.04
77075TCX-rays bone survey complete                       A   0.00   2.25     2.16     2.25NA   2.16 NA  0.01   2.26   2.17   2.26   2.17  1XXX.00.00.0000000             25.5217 010 99      2.96   2.96   0.01
7707526X-rays bone survey complete                       A   0.54   0.23     0.21     0.23     0.21     0.03   0.80   0.78   0.80   0.78  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77076  X-rays bone survey infant                         A   0.70   2.22     2.26     2.22NA   2.26 NA  0.05   2.97   3.01   2.97   3.01  1XXX.00.00.0000000             25.5217 090 99      3.23   3.23   0.06
77076TCX-rays bone survey infant                         A   0.00   1.95     1.99     1.95NA   1.99 NA  0.01   1.96   2.00   1.96   2.00  1XXX.00.00.0000000             25.5217 010 99      2.96   2.96   0.02
7707626X-rays bone survey infant                         A   0.70   0.27     0.27     0.27     0.27     0.04   1.01   1.01   1.01   1.01  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77077  Joint survey single view                          A   0.31   0.89     0.82     0.89NA   0.82 NA  0.05   1.25   1.18   1.25   1.18  1XXX.00.00.0000000             25.5217 090 99      1.88   1.88   0.06
77077TCJoint survey single view                          A   0.00   0.75     0.67     0.75NA   0.67 NA  0.01   0.76   0.68   0.76   0.68  1XXX.00.00.0000000             25.5217 010 99      1.74   1.74   0.02
7707726Joint survey single view                          A   0.31   0.14     0.15     0.14     0.15     0.04   0.49   0.50   0.49   0.50  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77078  Ct bone density axial                             A   0.25   4.40     3.55     4.40NA   3.55 NA  0.02   4.67   3.82   4.67   3.82  1XXX.00.00.0000000             25.5217 090 99      2.86   2.86   0.02
77078TCCt bone density axial                             A   0.00   4.30     3.45     4.30NA   3.45 NA  0.01   4.31   3.46   4.31   3.46  1XXX.00.00.0000000             25.5217 010 99      2.76   2.76   0.01
7707826Ct bone density axial                             A   0.25   0.10     0.10     0.10     0.10     0.01   0.36   0.36   0.36   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77079  Ct bone density peripheral                        A   0.22   1.26     0.92     1.26NA   0.92 NA  0.02   1.50   1.16   1.50   1.16  1XXX.00.00.0000000             25.5217 010 99      4.50   4.50   0.05
77079TCCt bone density peripheral                        A   0.00   1.17     0.82     1.17NA   0.82 NA  0.01   1.18   0.83   1.18   0.83  1XXX.00.00.0000000             25.5217 010 99      4.41   4.41   0.04
7707926Ct bone density peripheral                        A   0.22   0.09     0.10     0.09     0.10     0.01   0.32   0.33   0.32   0.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77080  Dxa bone density axial                            A   0.31   3.32     3.32     3.32NA   3.32 NA  0.19   3.82   3.82   3.82   3.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77080TCDxa bone density axial                            A   0.00   3.22     3.22     3.22NA   3.22 NA  0.18   3.40   3.40   3.40   3.40  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7708026Dxa bone density axial                            A   0.31   0.10     0.10     0.10     0.10     0.01   0.42   0.42   0.42   0.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77081  Dxa bone density/peripheral                       A   0.22   0.61     0.61     0.61NA   0.61 NA  0.02   0.85   0.85   0.85   0.85  1XXX.00.00.0000000             25.5217 090 99      1.30   1.30   0.03
77081TCDxa bone density/peripheral                       A   0.00   0.55     0.55     0.55NA   0.55 NA  0.01   0.56   0.56   0.56   0.56  1XXX.00.00.0000000             25.5217 010 99      1.24   1.24   0.02
7708126Dxa bone density/peripheral                       A   0.22   0.06     0.06     0.06     0.06     0.01   0.29   0.29   0.29   0.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77082  Dxa bone density vert fx                          A   0.18   0.84     0.84     0.84NA   0.84 NA  0.06   1.08   1.08   1.08   1.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77082TCDxa bone density vert fx                          A   0.00   0.78     0.78     0.78NA   0.78 NA  0.05   0.83   0.83   0.83   0.83  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7708226Dxa bone density vert fx                          A   0.18   0.06     0.06     0.06     0.06     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77083  Radiographic absorptiometry                       A   0.20   0.53     0.47     0.53NA   0.47 NA  0.02   0.75   0.69   0.75   0.69  1XXX.00.00.0000000             25.5217 090 99      2.99   2.99   0.07
77083TCRadiographic absorptiometry                       A   0.00   0.45     0.38     0.45NA   0.38 NA  0.01   0.46   0.39   0.46   0.39  1XXX.00.00.0000000             25.5217 010 99      2.91   2.91   0.06
7708326Radiographic absorptiometry                       A   0.20   0.08     0.09     0.08     0.09     0.01   0.29   0.30   0.29   0.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77084  Magnetic image bone marrow                        A   1.60  13.94    11.03    13.94NA  11.03 NA  0.11  15.65  12.74  15.65  12.74  1XXX.00.00.0000000             25.5217 090 99     14.10  14.10   0.11
77084TCMagnetic image bone marrow                        A   0.00  13.27    10.42    13.27NA  10.42 NA  0.01  13.28  10.43  13.28  10.43  1XXX.00.00.0000000             25.5217 010 99     13.43  13.43   0.01
7708426Magnetic image bone marrow                        A   1.60   0.67     0.61     0.67     0.61     0.10   2.37   2.31   2.37   2.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77261  Radiation therapy planning                        A   1.39   0.65     0.67     0.65     0.67     0.10   2.14   2.16   2.14   2.16  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77262  Radiation therapy planning                        A   2.11   0.93     0.95     0.93     0.95     0.18   3.22   3.24   3.22   3.24  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77263  Radiation therapy planning                        A   3.14   1.37     1.40     1.37     1.40     0.26   4.77   4.80   4.77   4.80  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77280  Set radiation therapy field                       A   0.70   4.85     4.57     4.85NA   4.57 NA  0.04   5.59   5.31   5.59   5.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77280TCSet radiation therapy field                       A   0.00   4.55     4.26     4.55NA   4.26 NA  0.01   4.56   4.27   4.56   4.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7728026Set radiation therapy field                       A   0.70   0.30     0.31     0.30     0.31     0.03   1.03   1.04   1.03   1.04  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77285  Set radiation therapy field                       A   1.05   8.69     8.31     8.69NA   8.31 NA  0.06   9.80   9.42   9.80   9.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77285TCSet radiation therapy field                       A   0.00   8.24     7.84     8.24NA   7.84 NA  0.01   8.25   7.85   8.25   7.85  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7728526Set radiation therapy field                       A   1.05   0.45     0.47     0.45     0.47     0.05   1.55   1.57   1.55   1.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77290  Set radiation therapy field                       A   1.56  14.04    13.80    14.04NA  13.80 NA  0.08  15.68  15.44  15.68  15.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77290TCSet radiation therapy field                       A   0.00  13.37    13.10    13.37NA  13.10 NA  0.01  13.38  13.11  13.38  13.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7729026Set radiation therapy field                       A   1.56   0.67     0.70     0.67     0.70     0.07   2.30   2.33   2.30   2.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77295  Set radiation therapy field                       A   4.56  11.86     8.01    11.86NA   8.01 NA  0.28  16.70  12.85  16.70  12.85  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77295TCSet radiation therapy field                       A   0.00   9.89     5.97     9.89NA   5.97 NA  0.04   9.93   6.01   9.93   6.01  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7729526Set radiation therapy field                       A   4.56   1.97     2.04     1.97     2.04     0.24   6.77   6.84   6.77   6.84  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77299  Radiation therapy planning                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77299TCRadiation therapy planning                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7729926Radiation therapy planning                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77300  Radiation therapy dose plan                       A   0.62   1.41     1.27     1.41NA   1.27 NA  0.04   2.07   1.93   2.07   1.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77300TCRadiation therapy dose plan                       A   0.00   1.14     0.99     1.14NA   0.99 NA  0.01   1.15   1.00   1.15   1.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7730026Radiation therapy dose plan                       A   0.62   0.27     0.28     0.27     0.28     0.03   0.92   0.93   0.92   0.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77301  Radiotherapy dose plan imrt                       A   7.99  53.19    45.27    53.19NA  45.27 NA  0.63  61.81  53.89  61.81  53.89  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77301TCRadiotherapy dose plan imrt                       A   0.00  49.73    41.70    49.73NA  41.70 NA  0.22  49.95  41.92  49.95  41.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7730126Radiotherapy dose plan imrt                       A   7.99   3.46     3.57     3.46     3.57     0.41  11.86  11.97  11.86  11.97  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77305  Teletx isodose plan simple                        A   0.70   1.22     0.98     1.22NA   0.98 NA  0.04   1.96   1.72   1.96   1.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77305TCTeletx isodose plan simple                        A   0.00   0.92     0.67     0.92NA   0.67 NA  0.01   0.93   0.68   0.93   0.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7730526Teletx isodose plan simple                        A   0.70   0.30     0.31     0.30     0.31     0.03   1.03   1.04   1.03   1.04  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77310  Teletx isodose plan intermed                      A   1.05   1.68     1.38     1.68NA   1.38 NA  0.06   2.79   2.49   2.79   2.49  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77310TCTeletx isodose plan intermed                      A   0.00   1.22     0.91     1.22NA   0.91 NA  0.01   1.23   0.92   1.23   0.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7731026Teletx isodose plan intermed                      A   1.05   0.46     0.47     0.46     0.47     0.05   1.56   1.57   1.56   1.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77315  Teletx isodose plan complex                       A   1.56   2.59     2.29     2.59NA   2.29 NA  0.08   4.23   3.93   4.23   3.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77315TCTeletx isodose plan complex                       A   0.00   1.91     1.59     1.91NA   1.59 NA  0.01   1.92   1.60   1.92   1.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7731526Teletx isodose plan complex                       A   1.56   0.68     0.70     0.68     0.70     0.07   2.31   2.33   2.31   2.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77321  Special teletx port plan                          A   0.95   2.17     1.63     2.17NA   1.63 NA  0.05   3.17   2.63   3.17   2.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77321TCSpecial teletx port plan                          A   0.00   1.76     1.21     1.76NA   1.21 NA  0.01   1.77   1.22   1.77   1.22  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7732126Special teletx port plan                          A   0.95   0.41     0.42     0.41     0.42     0.04   1.40   1.41   1.40   1.41  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77326  Brachytx isodose calc simp                        A   0.93   3.30     3.11     3.30NA   3.11 NA  0.07   4.30   4.11   4.30   4.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77326TCBrachytx isodose calc simp                        A   0.00   2.90     2.69     2.90NA   2.69 NA  0.03   2.93   2.72   2.93   2.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7732626Brachytx isodose calc simp                        A   0.93   0.40     0.42     0.40     0.42     0.04   1.37   1.39   1.37   1.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77327  Brachytx isodose calc interm                      A   1.39   4.59     4.28     4.59NA   4.28 NA  0.10   6.08   5.77   6.08   5.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77327TCBrachytx isodose calc interm                      A   0.00   3.99     3.66     3.99NA   3.66 NA  0.03   4.02   3.69   4.02   3.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7732726Brachytx isodose calc interm                      A   1.39   0.60     0.62     0.60     0.62     0.07   2.06   2.08   2.06   2.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77328  Brachytx isodose plan compl                       A   2.09   5.98     5.49     5.98NA   5.49 NA  0.14   8.21   7.72   8.21   7.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77328TCBrachytx isodose plan compl                       A   0.00   5.08     4.56     5.08NA   4.56 NA  0.04   5.12   4.60   5.12   4.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7732826Brachytx isodose plan compl                       A   2.09   0.90     0.93     0.90     0.93     0.10   3.09   3.12   3.09   3.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77331  Special radiation dosimetry                       A   0.87   0.95     0.91     0.95NA   0.91 NA  0.05   1.87   1.83   1.87   1.83  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77331TCSpecial radiation dosimetry                       A   0.00   0.57     0.52     0.57NA   0.52 NA  0.01   0.58   0.53   0.58   0.53  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7733126Special radiation dosimetry                       A   0.87   0.38     0.39     0.38     0.39     0.04   1.29   1.30   1.29   1.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77332  Radiation treatment aid(s)                        A   0.54   1.75     1.63     1.75NA   1.63 NA  0.04   2.33   2.21   2.33   2.21  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77332TCRadiation treatment aid(s)                        A   0.00   1.52     1.39     1.52NA   1.39 NA  0.01   1.53   1.40   1.53   1.40  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7733226Radiation treatment aid(s)                        A   0.54   0.23     0.24     0.23     0.24     0.03   0.80   0.81   0.80   0.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77333  Radiation treatment aid(s)                        A   0.84   0.89     0.62     0.89NA   0.62 NA  0.05   1.78   1.51   1.78   1.51  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77333TCRadiation treatment aid(s)                        A   0.00   0.52     0.24     0.52NA   0.24 NA  0.01   0.53   0.25   0.53   0.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7733326Radiation treatment aid(s)                        A   0.84   0.37     0.38     0.37     0.38     0.04   1.25   1.26   1.25   1.26  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77334  Radiation treatment aid(s)                        A   1.24   3.25     2.89     3.25NA   2.89 NA  0.06   4.55   4.19   4.55   4.19  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77334TCRadiation treatment aid(s)                        A   0.00   2.71     2.34     2.71NA   2.34 NA  0.01   2.72   2.35   2.72   2.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7733426Radiation treatment aid(s)                        A   1.24   0.54     0.55     0.54     0.55     0.05   1.83   1.84   1.83   1.84  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77336  Radiation physics consult                         A   0.00   1.53     1.14     1.53NA   1.14 NA  0.01   1.54   1.15   1.54   1.15  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77338  Design mlc device for imrt                        A   4.29   9.65     9.65     9.65NA   9.65 NA  0.27  14.21  14.21  14.21  14.21  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77338TCDesign mlc device for imrt                        A   0.00   7.73     7.73     7.73NA   7.73 NA  0.04   7.77   7.77   7.77   7.77  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7733826Design mlc device for imrt                        A   4.29   1.92     1.92     1.92     1.92     0.23   6.44   6.44   6.44   6.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77370  Radiation physics consult                         A   0.00   3.41     3.04     3.41NA   3.04 NA  0.04   3.45   3.08   3.45   3.08  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77371  Srs multisource                                   C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77372  Srs linear based                                  A   0.00  25.18    23.02    25.18NA  23.02 NA  0.05  25.23  23.07  25.23  23.07  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77373  Sbrt delivery                                     A   0.00  47.02    43.31    47.02NA  43.31 NA  0.07  47.09  43.38  47.09  43.38  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77399  External radiation dosimetry                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77399TCExternal radiation dosimetry                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7739926External radiation dosimetry                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77401  Radiation treatment delivery                      A   0.00   0.75     0.53     0.75NA   0.53 NA  0.01   0.76   0.54   0.76   0.54  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77402  Radiation treatment delivery                      A   0.00   5.20     5.89     5.20NA   5.89 NA  0.01   5.21   5.90   5.21   5.90  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77403  Radiation treatment delivery                      A   0.00   3.87     3.82     3.87NA   3.82 NA  0.01   3.88   3.83   3.88   3.83  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77404  Radiation treatment delivery                      A   0.00   4.31     4.27     4.31NA   4.27 NA  0.01   4.32   4.28   4.32   4.28  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77406  Radiation treatment delivery                      A   0.00   4.35     4.32     4.35NA   4.32 NA  0.01   4.36   4.33   4.36   4.33  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77407  Radiation treatment delivery                      A   0.00   7.55     8.00     7.55NA   8.00 NA  0.01   7.56   8.01   7.56   8.01  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77408  Radiation treatment delivery                      A   0.00   5.28     5.26     5.28NA   5.26 NA  0.01   5.29   5.27   5.29   5.27  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77409  Radiation treatment delivery                      A   0.00   5.87     5.89     5.87NA   5.89 NA  0.01   5.88   5.90   5.88   5.90  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77411  Radiation treatment delivery                      A   0.00   5.84     5.86     5.84NA   5.86 NA  0.01   5.85   5.87   5.85   5.87  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77412  Radiation treatment delivery                      A   0.00   6.89     6.92     6.89NA   6.92 NA  0.01   6.90   6.93   6.90   6.93  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77413  Radiation treatment delivery                      A   0.00   6.93     6.96     6.93NA   6.96 NA  0.01   6.94   6.97   6.94   6.97  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77414  Radiation treatment delivery                      A   0.00   7.76     7.84     7.76NA   7.84 NA  0.01   7.77   7.85   7.77   7.85  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77416  Radiation treatment delivery                      A   0.00   7.80     7.89     7.80NA   7.89 NA  0.01   7.81   7.90   7.81   7.90  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77417  Radiology port film(s)                            A   0.00   0.43     0.37     0.43NA   0.37 NA  0.01   0.44   0.38   0.44   0.38  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
77418  Radiation tx delivery imrt                        A   0.00  15.38    13.38    15.38NA  13.38 NA  0.01  15.39  13.39  15.39  13.39  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77421  Stereoscopic x-ray guidance                       A   0.39   2.84     2.46     2.84NA   2.46 NA  0.02   3.25   2.87   3.25   2.87  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77421TCStereoscopic x-ray guidance                       A   0.00   2.67     2.29     2.67NA   2.29 NA  0.01   2.68   2.30   2.68   2.30  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
7742126Stereoscopic x-ray guidance                       A   0.39   0.17     0.17     0.17     0.17     0.01   0.57   0.57   0.57   0.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77422  Neutron beam tx simple                            A   0.00   5.89     5.35     5.89NA   5.35 NA  0.01   5.90   5.36   5.90   5.36  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77423  Neutron beam tx complex                           A   0.00   7.49     7.56     7.49NA   7.56 NA  0.01   7.50   7.57   7.50   7.57  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77427  Radiation tx management x5                        A   2.92   1.59     1.52     1.59     1.52     0.23   4.74   4.67   4.74   4.67  2XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
77431  Radiation therapy management                      A   1.81   0.97     0.99     0.97     0.99     0.14   2.92   2.94   2.92   2.94  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77432  Stereotactic radiation trmt                       A   7.92   3.49     3.57     3.49     3.57     0.65  12.06  12.14  12.06  12.14  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77435  Sbrt management                                   A  13.00   5.91     5.96     5.96     5.96     1.07  19.98  20.03  20.03  20.03  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77470  Special radiation treatment                       A   2.09   3.77     2.17     3.77NA   2.17 NA  0.11   5.97   4.37   5.97   4.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77470TCSpecial radiation treatment                       A   0.00   2.87     1.24     2.87NA   1.24 NA  0.01   2.88   1.25   2.88   1.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7747026Special radiation treatment                       A   2.09   0.90     0.93     0.90     0.93     0.10   3.09   3.12   3.09   3.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77499  Radiation therapy management                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77499TCRadiation therapy management                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7749926Radiation therapy management                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77520  Proton trmt simple w/o comp                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77522  Proton trmt simple w/comp                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77523  Proton trmt intermediate                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77525  Proton treatment complex                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77600  Hyperthermia treatment                            R   1.56  10.41    10.46    10.41NA  10.46 NA  0.10  12.07  12.12  12.07  12.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77600TCHyperthermia treatment                            R   0.00   9.73     9.76     9.73NA   9.76 NA  0.03   9.76   9.79   9.76   9.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7760026Hyperthermia treatment                            R   1.56   0.68     0.70     0.68     0.70     0.07   2.31   2.33   2.31   2.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77605  Hyperthermia treatment                            R   2.09  25.03    30.44    25.03NA  30.44 NA  0.41  27.53  32.94  27.53  32.94  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77605TCHyperthermia treatment                            R   0.00  24.20    29.53    24.20NA  29.53 NA  0.03  24.23  29.56  24.23  29.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7760526Hyperthermia treatment                            R   2.09   0.83     0.91     0.83     0.91     0.38   3.30   3.38   3.30   3.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77610  Hyperthermia treatment                            R   1.56  23.41    27.92    23.41NA  27.92 NA  0.10  25.07  29.58  25.07  29.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77610TCHyperthermia treatment                            R   0.00  22.78    27.24    22.78NA  27.24 NA  0.03  22.81  27.27  22.81  27.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7761026Hyperthermia treatment                            R   1.56   0.63     0.68     0.63     0.68     0.07   2.26   2.31   2.26   2.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77615  Hyperthermia treatment                            R   2.09  26.55    26.45    26.55NA  26.45 NA  0.17  28.81  28.71  28.81  28.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77615TCHyperthermia treatment                            R   0.00  25.65    25.51    25.65NA  25.51 NA  0.07  25.72  25.58  25.72  25.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7761526Hyperthermia treatment                            R   2.09   0.90     0.94     0.90     0.94     0.10   3.09   3.13   3.09   3.13  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77620  Hyperthermia treatment                            R   1.56  12.57    14.24    12.57NA  14.24 NA  0.08  14.21  15.88  14.21  15.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77620TCHyperthermia treatment                            R   0.00  11.95    13.56    11.95NA  13.56 NA  0.04  11.99  13.60  11.99  13.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7762026Hyperthermia treatment                            R   1.56   0.62     0.68     0.62     0.68     0.04   2.22   2.28   2.22   2.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77750  Infuse radioactive materials                      A   5.00   5.13     5.17     5.13NA   5.17 NA  0.29  10.42  10.46  10.42  10.46  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77750TCInfuse radioactive materials                      A   0.00   2.98     2.94     2.98NA   2.94 NA  0.03   3.01   2.97   3.01   2.97  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7775026Infuse radioactive materials                      A   5.00   2.15     2.23     2.15     2.23     0.26   7.41   7.49   7.41   7.49  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77761  Apply intrcav radiat simple                       A   3.85   6.80     6.72     6.80NA   6.72 NA  0.24  10.89  10.81  10.89  10.81  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77761TCApply intrcav radiat simple                       A   0.00   5.17     5.02     5.17NA   5.02 NA  0.04   5.21   5.06   5.21   5.06  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7776126Apply intrcav radiat simple                       A   3.85   1.63     1.70     1.63     1.70     0.20   5.68   5.75   5.68   5.75  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77762  Apply intrcav radiat interm                       A   5.76   8.52     8.35     8.52NA   8.35 NA  0.35  14.63  14.46  14.63  14.46  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77762TCApply intrcav radiat interm                       A   0.00   6.05     5.80     6.05NA   5.80 NA  0.05   6.10   5.85   6.10   5.85  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7776226Apply intrcav radiat interm                       A   5.76   2.47     2.55     2.47     2.55     0.30   8.53   8.61   8.53   8.61  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77763  Apply intrcav radiat compl                        A   8.66  11.54    11.35    11.54NA  11.35 NA  0.50  20.70  20.51  20.70  20.51  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77763TCApply intrcav radiat compl                        A   0.00   7.82     7.52     7.82NA   7.52 NA  0.07   7.89   7.59   7.89   7.59  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7776326Apply intrcav radiat compl                        A   8.66   3.72     3.83     3.72     3.83     0.43  12.81  12.92  12.81  12.92  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77776  Apply interstit radiat simpl                      A   4.70   7.42     7.17     7.42NA   7.17 NA  0.36  12.48  12.23  12.48  12.23  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77776TCApply interstit radiat simpl                      A   0.00   5.40     5.05     5.40NA   5.05 NA  0.05   5.45   5.10   5.45   5.10  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7777626Apply interstit radiat simpl                      A   4.70   2.02     2.12     2.02     2.12     0.31   7.03   7.13   7.03   7.13  1090.00.00.0000020             25.5217 090 99      0.00   0.00   0.00
77777  Apply interstit radiat inter                      A   7.52   9.22     8.83     9.22NA   8.83 NA  0.54  17.28  16.89  17.28  16.89  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77777TCApply interstit radiat inter                      A   0.00   5.90     5.48     5.90NA   5.48 NA  0.05   5.95   5.53   5.95   5.53  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7777726Apply interstit radiat inter                      A   7.52   3.32     3.35     3.32     3.35     0.49  11.33  11.36  11.33  11.36  1090.00.00.0000020             25.5217 090 99      0.00   0.00   0.00
77778  Apply interstit radiat compl                      A  11.32  12.88    12.62    12.88NA  12.62 NA  0.68  24.88  24.62  24.88  24.62  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77778TCApply interstit radiat compl                      A   0.00   8.02     7.63     8.02NA   7.63 NA  0.08   8.10   7.71   8.10   7.71  1090.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7777826Apply interstit radiat compl                      A  11.32   4.86     4.99     4.86     4.99     0.60  16.78  16.91  16.78  16.91  1090.00.00.0000020             25.5217 090 99      0.00   0.00   0.00
77785  Hdr brachytx 1 channel                            A   1.42   4.99     5.60     4.99NA   5.60 NA  0.10   6.51   7.12   6.51   7.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77785TCHdr brachytx 1 channel                            A   0.00   4.37     4.97     4.37NA   4.97 NA  0.03   4.40   5.00   4.40   5.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7778526Hdr brachytx 1 channel                            A   1.42   0.62     0.63     0.62     0.63     0.07   2.11   2.12   2.11   2.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77786  Hdr brachytx 2-12 channel                         A   3.25  13.44    12.46    13.44NA  12.46 NA  0.21  16.90  15.92  16.90  15.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77786TCHdr brachytx 2-12 channel                         A   0.00  12.07    11.00    12.07NA  11.00 NA  0.05  12.12  11.05  12.12  11.05  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7778626Hdr brachytx 2-12 channel                         A   3.25   1.37     1.46     1.37     1.46     0.16   4.78   4.87   4.78   4.87  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77787  Hdr brachytx over 12 chan                         A   4.89  21.73    22.05    21.73NA  22.05 NA  0.34  26.96  27.28  26.96  27.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77787TCHdr brachytx over 12 chan                         A   0.00  19.58    19.85    19.58NA  19.85 NA  0.08  19.66  19.93  19.66  19.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7778726Hdr brachytx over 12 chan                         A   4.89   2.15     2.20     2.15     2.20     0.26   7.30   7.35   7.30   7.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77789  Apply surface radiation                           A   1.14   2.09     2.12     2.09NA   2.12 NA  0.06   3.29   3.32   3.29   3.32  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77789TCApply surface radiation                           A   0.00   1.58     1.59     1.58NA   1.59 NA  0.01   1.59   1.60   1.59   1.60  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7778926Apply surface radiation                           A   1.14   0.51     0.53     0.51     0.53     0.05   1.70   1.72   1.70   1.72  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77790  Radiation handling                                A   1.05   1.59     1.60     1.59NA   1.60 NA  0.05   2.69   2.70   2.69   2.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77790TCRadiation handling                                A   0.00   1.14     1.13     1.14NA   1.13 NA  0.01   1.15   1.14   1.15   1.14  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7779026Radiation handling                                A   1.05   0.45     0.47     0.45     0.47     0.04   1.54   1.56   1.54   1.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77799  Radium/radioisotope therapy                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
77799TCRadium/radioisotope therapy                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7779926Radium/radioisotope therapy                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78000  Thyroid single uptake                             A   0.19   1.91     1.81     1.91NA   1.81 NA  0.02   2.12   2.02   2.12   2.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78000TCThyroid single uptake                             A   0.00   1.83     1.74     1.83NA   1.74 NA  0.01   1.84   1.75   1.84   1.75  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7800026Thyroid single uptake                             A   0.19   0.08     0.07     0.08     0.07     0.01   0.28   0.27   0.28   0.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78001  Thyroid multiple uptakes                          A   0.26   2.43     2.32     2.43NA   2.32 NA  0.04   2.73   2.62   2.73   2.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78001TCThyroid multiple uptakes                          A   0.00   2.32     2.23     2.32NA   2.23 NA  0.03   2.35   2.26   2.35   2.26  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7800126Thyroid multiple uptakes                          A   0.26   0.11     0.09     0.11     0.09     0.01   0.38   0.36   0.38   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78003  Thyroid suppress/stimul                           A   0.33   2.02     1.94     2.02NA   1.94 NA  0.02   2.37   2.29   2.37   2.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78003TCThyroid suppress/stimul                           A   0.00   1.88     1.82     1.88NA   1.82 NA  0.01   1.89   1.83   1.89   1.83  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7800326Thyroid suppress/stimul                           A   0.33   0.14     0.12     0.14     0.12     0.01   0.48   0.46   0.48   0.46  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78006  Thyroid imaging with uptake                       A   0.49   6.41     6.33     6.41NA   6.33 NA  0.06   6.96   6.88   6.96   6.88  1XXX.00.00.0000000             25.5217 090 99      8.76   8.76   0.07
78006TCThyroid imaging with uptake                       A   0.00   6.21     6.16     6.21NA   6.16 NA  0.03   6.24   6.19   6.24   6.19  1XXX.00.00.0000000             25.5217 010 99      8.56   8.56   0.04
7800626Thyroid imaging with uptake                       A   0.49   0.20     0.17     0.20     0.17     0.03   0.72   0.69   0.72   0.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78007  Thyroid image mult uptakes                        A   0.50   5.22     6.72     5.22NA   6.72 NA  0.06   5.78   7.28   5.78   7.28  1XXX.00.00.0000000             25.5217 090 99      8.76   8.76   0.08
78007TCThyroid image mult uptakes                        A   0.00   5.01     6.54     5.01NA   6.54 NA  0.03   5.04   6.57   5.04   6.57  1XXX.00.00.0000000             25.5217 010 99      8.55   8.55   0.05
7800726Thyroid image mult uptakes                        A   0.50   0.21     0.18     0.21     0.18     0.03   0.74   0.71   0.74   0.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78010  Thyroid imaging                                   A   0.39   4.39     4.34     4.39NA   4.34 NA  0.04   4.82   4.77   4.82   4.77  1XXX.00.00.0000000             25.5217 090 99      5.33   5.33   0.05
78010TCThyroid imaging                                   A   0.00   4.23     4.20     4.23NA   4.20 NA  0.03   4.26   4.23   4.26   4.23  1XXX.00.00.0000000             25.5217 010 99      5.17   5.17   0.04
7801026Thyroid imaging                                   A   0.39   0.16     0.14     0.16     0.14     0.01   0.56   0.54   0.56   0.54  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78011  Thyroid imaging with flow                         A   0.45   4.80     4.56     4.80NA   4.56 NA  0.06   5.31   5.07   5.31   5.07  1XXX.00.00.0000000             25.5217 090 99      5.36   5.36   0.06
78011TCThyroid imaging with flow                         A   0.00   4.61     4.39     4.61NA   4.39 NA  0.03   4.64   4.42   4.64   4.42  1XXX.00.00.0000000             25.5217 010 99      5.17   5.17   0.03
7801126Thyroid imaging with flow                         A   0.45   0.19     0.17     0.19     0.17     0.03   0.67   0.65   0.67   0.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78015  Thyroid met imaging                               A   0.67   5.62     5.44     5.62NA   5.44 NA  0.07   6.36   6.18   6.36   6.18  1XXX.00.00.0000000             25.5217 090 99     11.56  11.56   0.10
78015TCThyroid met imaging                               A   0.00   5.36     5.22     5.36NA   5.22 NA  0.03   5.39   5.25   5.39   5.25  1XXX.00.00.0000000             25.5217 010 99     11.30  11.30   0.06
7801526Thyroid met imaging                               A   0.67   0.26     0.22     0.26     0.22     0.04   0.97   0.93   0.97   0.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78016  Thyroid met imaging/studies                       A   0.82   8.12     7.14     8.12NA   7.14 NA  0.06   9.00   8.02   9.00   8.02  1XXX.00.00.0000000             25.5217 090 99     11.58  11.58   0.07
78016TCThyroid met imaging/studies                       A   0.00   7.86     7.00     7.86NA   7.00 NA  0.03   7.89   7.03   7.89   7.03  1XXX.00.00.0000000             25.5217 010 99     11.32  11.32   0.04
7801626Thyroid met imaging/studies                       A   0.82   0.26     0.14     0.26     0.14     0.03   1.11   0.99   1.11   0.99  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78018  Thyroid met imaging body                          A   0.86   8.48     7.92     8.48NA   7.92 NA  0.07   9.41   8.85   9.41   8.85  1XXX.00.00.0000000             25.5217 090 99     11.66  11.66   0.08
78018TCThyroid met imaging body                          A   0.00   8.15     7.64     8.15NA   7.64 NA  0.03   8.18   7.67   8.18   7.67  1XXX.00.00.0000000             25.5217 010 99     11.33  11.33   0.04
7801826Thyroid met imaging body                          A   0.86   0.33     0.28     0.33     0.28     0.04   1.23   1.18   1.23   1.18  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78020  Thyroid met uptake                                A   0.60   1.92     1.67     1.92NA   1.67 NA  0.04   2.56   2.31   2.56   2.31  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78020TCThyroid met uptake                                A   0.00   1.69     1.50     1.69NA   1.50 NA  0.01   1.70   1.51   1.70   1.51  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7802026Thyroid met uptake                                A   0.60   0.23     0.17     0.23     0.17     0.03   0.86   0.80   0.86   0.80  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78070  Parathyroid nuclear imaging                       A   0.82   4.00     3.41     4.00NA   3.41 NA  0.07   4.89   4.30   4.89   4.30  1XXX.00.00.0000000             25.5217 090 99      8.86   8.86   0.11
78070TCParathyroid nuclear imaging                       A   0.00   3.67     3.13     3.67NA   3.13 NA  0.03   3.70   3.16   3.70   3.16  1XXX.00.00.0000000             25.5217 010 99      8.53   8.53   0.07
7807026Parathyroid nuclear imaging                       A   0.82   0.33     0.28     0.33     0.28     0.04   1.19   1.14   1.19   1.14  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78075  Adrenal nuclear imaging                           A   0.74  11.78    11.21    11.78NA  11.21 NA  0.08  12.60  12.03  12.60  12.03  1XXX.00.00.0000000             25.5217 090 99     32.51  32.51   0.15
78075TCAdrenal nuclear imaging                           A   0.00  11.49    10.98    11.49NA  10.98 NA  0.04  11.53  11.02  11.53  11.02  1XXX.00.00.0000000             25.5217 010 99     32.22  32.22   0.11
7807526Adrenal nuclear imaging                           A   0.74   0.29     0.23     0.29     0.23     0.04   1.07   1.01   1.07   1.01  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78099  Endocrine nuclear procedure                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78099TCEndocrine nuclear procedure                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7809926Endocrine nuclear procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78102  Bone marrow imaging ltd                           A   0.55   4.31     4.08     4.31NA   4.08 NA  0.06   4.92   4.69   4.92   4.69  1XXX.00.00.0000000             25.5217 090 99     10.21  10.21   0.10
78102TCBone marrow imaging ltd                           A   0.00   4.10     3.91     4.10NA   3.91 NA  0.03   4.13   3.94   4.13   3.94  1XXX.00.00.0000000             25.5217 010 99     10.00  10.00   0.07
7810226Bone marrow imaging ltd                           A   0.55   0.21     0.17     0.21     0.17     0.03   0.79   0.75   0.79   0.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78103  Bone marrow imaging mult                          A   0.75   5.67     5.27     5.67NA   5.27 NA  0.07   6.49   6.09   6.49   6.09  1XXX.00.00.0000000             25.5217 090 99     10.29  10.29   0.10
78103TCBone marrow imaging mult                          A   0.00   5.39     5.05     5.39NA   5.05 NA  0.03   5.42   5.08   5.42   5.08  1XXX.00.00.0000000             25.5217 010 99     10.01  10.01   0.06
7810326Bone marrow imaging mult                          A   0.75   0.28     0.22     0.28     0.22     0.04   1.07   1.01   1.07   1.01  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78104  Bone marrow imaging body                          A   0.80   6.50     5.98     6.50NA   5.98 NA  0.07   7.37   6.85   7.37   6.85  1XXX.00.00.0000000             25.5217 090 99     10.34  10.34   0.09
78104TCBone marrow imaging body                          A   0.00   6.18     5.73     6.18NA   5.73 NA  0.03   6.21   5.76   6.21   5.76  1XXX.00.00.0000000             25.5217 010 99     10.02  10.02   0.05
7810426Bone marrow imaging body                          A   0.80   0.32     0.25     0.32     0.25     0.04   1.16   1.09   1.16   1.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78110  Plasma volume single                              A   0.19   2.22     2.18     2.22NA   2.18 NA  0.04   2.45   2.41   2.45   2.41  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78110TCPlasma volume single                              A   0.00   2.14     2.11     2.14NA   2.11 NA  0.03   2.17   2.14   2.17   2.14  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7811026Plasma volume single                              A   0.19   0.08     0.07     0.08     0.07     0.01   0.28   0.27   0.28   0.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78111  Plasma volume multiple                            A   0.22   2.33     1.81     2.33NA   1.81 NA  0.04   2.59   2.07   2.59   2.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78111TCPlasma volume multiple                            A   0.00   2.25     1.76     2.25NA   1.76 NA  0.03   2.28   1.79   2.28   1.79  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7811126Plasma volume multiple                            A   0.22   0.08     0.05     0.08     0.05     0.01   0.31   0.28   0.31   0.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78120  Red cell mass single                              A   0.23   2.33     2.14     2.33NA   2.14 NA  0.04   2.60   2.41   2.60   2.41  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78120TCRed cell mass single                              A   0.00   2.23     2.05     2.23NA   2.05 NA  0.03   2.26   2.08   2.26   2.08  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7812026Red cell mass single                              A   0.23   0.10     0.09     0.10     0.09     0.01   0.34   0.33   0.34   0.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78121  Red cell mass multiple                            A   0.32   2.62     2.25     2.62NA   2.25 NA  0.04   2.98   2.61   2.98   2.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78121TCRed cell mass multiple                            A   0.00   2.49     2.13     2.49NA   2.13 NA  0.03   2.52   2.16   2.52   2.16  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7812126Red cell mass multiple                            A   0.32   0.13     0.12     0.13     0.12     0.01   0.46   0.45   0.46   0.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78122  Blood volume                                      A   0.45   2.83     2.09     2.83NA   2.09 NA  0.04   3.32   2.58   3.32   2.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78122TCBlood volume                                      A   0.00   2.66     1.96     2.66NA   1.96 NA  0.03   2.69   1.99   2.69   1.99  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7812226Blood volume                                      A   0.45   0.17     0.13     0.17     0.13     0.01   0.63   0.59   0.63   0.59  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78130  Red cell survival study                           A   0.61   3.89     3.58     3.89NA   3.58 NA  0.08   4.58   4.27   4.58   4.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78130TCRed cell survival study                           A   0.00   3.63     3.35     3.63NA   3.35 NA  0.04   3.67   3.39   3.67   3.39  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7813026Red cell survival study                           A   0.61   0.26     0.23     0.26     0.23     0.04   0.91   0.88   0.91   0.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78135  Red cell survival kinetics                        A   0.64   9.44     9.28     9.44NA   9.28 NA  0.07  10.15   9.99  10.15   9.99  1XXX.00.00.0000000             25.5217 090 99     16.61  16.61   0.09
78135TCRed cell survival kinetics                        A   0.00   9.17     9.03     9.17NA   9.03 NA  0.03   9.20   9.06   9.20   9.06  1XXX.00.00.0000000             25.5217 010 99     16.34  16.34   0.05
7813526Red cell survival kinetics                        A   0.64   0.27     0.25     0.27     0.25     0.04   0.95   0.93   0.95   0.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78140  Red cell sequestration                            A   0.61   3.43     2.90     3.43NA   2.90 NA  0.07   4.11   3.58   4.11   3.58  1XXX.00.00.0000000             25.5217 090 99     16.49  16.49   0.19
78140TCRed cell sequestration                            A   0.00   3.18     2.68     3.18NA   2.68 NA  0.03   3.21   2.71   3.21   2.71  1XXX.00.00.0000000             25.5217 010 99     16.24  16.24   0.15
7814026Red cell sequestration                            A   0.61   0.25     0.22     0.25     0.22     0.04   0.90   0.87   0.90   0.87  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78185  Spleen imaging                                    A   0.40   5.50     5.42     5.50NA   5.42 NA  0.04   5.94   5.86   5.94   5.86  1XXX.00.00.0000000             25.5217 090 99     10.18  10.18   0.07
78185TCSpleen imaging                                    A   0.00   5.33     5.27     5.33NA   5.27 NA  0.03   5.36   5.30   5.36   5.30  1XXX.00.00.0000000             25.5217 010 99     10.01  10.01   0.06
7818526Spleen imaging                                    A   0.40   0.17     0.15     0.17     0.15     0.01   0.58   0.56   0.58   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78190  Platelet survival kinetics                        A   1.09  10.02     9.56    10.02NA   9.56 NA  0.07  11.18  10.72  11.18  10.72  1XXX.00.00.0000000             25.5217 090 99      7.23   7.23   0.06
78190TCPlatelet survival kinetics                        A   0.00   9.58     9.13     9.58NA   9.13 NA  0.03   9.61   9.16   9.61   9.16  1XXX.00.00.0000000             25.5217 010 99      6.79   6.79   0.02
7819026Platelet survival kinetics                        A   1.09   0.44     0.43     0.44     0.43     0.04   1.57   1.56   1.57   1.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78191  Platelet survival                                 A   0.61   4.55     3.60     4.55NA   3.60 NA  0.08   5.24   4.29   5.24   4.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78191TCPlatelet survival                                 A   0.00   4.30     3.37     4.30NA   3.37 NA  0.04   4.34   3.41   4.34   3.41  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7819126Platelet survival                                 A   0.61   0.25     0.23     0.25     0.23     0.04   0.90   0.88   0.90   0.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78195  Lymph system imaging                              A   1.20   9.11     8.87     9.11NA   8.87 NA  0.10  10.41  10.17  10.41  10.17  1XXX.00.00.0000000             25.5217 090 99     10.52  10.52   0.10
78195TCLymph system imaging                              A   0.00   8.63     8.46     8.63NA   8.46 NA  0.03   8.66   8.49   8.66   8.49  1XXX.00.00.0000000             25.5217 010 99     10.04  10.04   0.03
7819526Lymph system imaging                              A   1.20   0.48     0.41     0.48     0.41     0.07   1.75   1.68   1.75   1.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78199  Blood/lymph nuclear exam                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78199TCBlood/lymph nuclear exam                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7819926Blood/lymph nuclear exam                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78201  Liver imaging                                     A   0.44   4.99     4.92     4.99NA   4.92 NA  0.07   5.50   5.43   5.50   5.43  1XXX.00.00.0000000             25.5217 090 99     10.49  10.49   0.10
78201TCLiver imaging                                     A   0.00   4.82     4.77     4.82NA   4.77 NA  0.03   4.85   4.80   4.85   4.80  1XXX.00.00.0000000             25.5217 010 99     10.32  10.32   0.06
7820126Liver imaging                                     A   0.44   0.17     0.15     0.17     0.15     0.04   0.65   0.63   0.65   0.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78202  Liver imaging with flow                           A   0.51   5.43     5.04     5.43NA   5.04 NA  0.04   5.98   5.59   5.98   5.59  1XXX.00.00.0000000             25.5217 090 99     10.51  10.51   0.07
78202TCLiver imaging with flow                           A   0.00   5.25     4.90     5.25NA   4.90 NA  0.03   5.28   4.93   5.28   4.93  1XXX.00.00.0000000             25.5217 010 99     10.33  10.33   0.06
7820226Liver imaging with flow                           A   0.51   0.18     0.14     0.18     0.14     0.01   0.70   0.66   0.70   0.66  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78205  Liver imaging (3D)                                A   0.71   5.94     5.18     5.94NA   5.18 NA  0.07   6.72   5.96   6.72   5.96  1XXX.00.00.0000000             25.5217 090 99     10.61  10.61   0.09
78205TCLiver imaging (3D)                                A   0.00   5.66     4.95     5.66NA   4.95 NA  0.03   5.69   4.98   5.69   4.98  1XXX.00.00.0000000             25.5217 010 99     10.33  10.33   0.05
7820526Liver imaging (3D)                                A   0.71   0.28     0.23     0.28     0.23     0.04   1.03   0.98   1.03   0.98  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78206  Liver image (3d) with flow                        A   0.96   9.25     8.72     9.25NA   8.72 NA  0.07  10.28   9.75  10.28   9.75  1XXX.00.00.0000000             25.5217 090 99     10.73  10.73   0.08
78206TCLiver image (3d) with flow                        A   0.00   8.87     8.40     8.87NA   8.40 NA  0.03   8.90   8.43   8.90   8.43  1XXX.00.00.0000000             25.5217 010 99     10.35  10.35   0.04
7820626Liver image (3d) with flow                        A   0.96   0.38     0.32     0.38     0.32     0.04   1.38   1.32   1.38   1.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78215  Liver and spleen imaging                          A   0.49   5.13     4.89     5.13NA   4.89 NA  0.06   5.68   5.44   5.68   5.44  1XXX.00.00.0000000             25.5217 090 99     10.53  10.53   0.09
78215TCLiver and spleen imaging                          A   0.00   4.93     4.71     4.93NA   4.71 NA  0.03   4.96   4.74   4.96   4.74  1XXX.00.00.0000000             25.5217 010 99     10.33  10.33   0.06
7821526Liver and spleen imaging                          A   0.49   0.20     0.18     0.20     0.18     0.03   0.72   0.70   0.72   0.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78216  Liver & spleen image/flow                         A   0.57   3.23     2.73     3.23NA   2.73 NA  0.06   3.86   3.36   3.86   3.36  1XXX.00.00.0000000             25.5217 090 99     10.51  10.51   0.13
78216TCLiver & spleen image/flow                         A   0.00   3.01     2.54     3.01NA   2.54 NA  0.03   3.04   2.57   3.04   2.57  1XXX.00.00.0000000             25.5217 010 99     10.29  10.29   0.10
7821626Liver & spleen image/flow                         A   0.57   0.22     0.19     0.22     0.19     0.03   0.82   0.79   0.82   0.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78220  Liver function study                              A   0.49   3.51     3.01     3.51NA   3.01 NA  0.04   4.04   3.54   4.04   3.54  1XXX.00.00.0000000             25.5217 090 99     10.49  10.49   0.10
78220TCLiver function study                              A   0.00   3.32     2.84     3.32NA   2.84 NA  0.03   3.35   2.87   3.35   2.87  1XXX.00.00.0000000             25.5217 010 99     10.30  10.30   0.09
7822026Liver function study                              A   0.49   0.19     0.17     0.19     0.17     0.01   0.69   0.67   0.69   0.67  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78223  Hepatobiliary imaging                             A   0.84   8.86     8.74     8.86NA   8.74 NA  0.07   9.77   9.65   9.77   9.65  1XXX.00.00.0000000             25.5217 090 99     10.69  10.69   0.08
78223TCHepatobiliary imaging                             A   0.00   8.52     8.44     8.52NA   8.44 NA  0.03   8.55   8.47   8.55   8.47  1XXX.00.00.0000000             25.5217 010 99     10.35  10.35   0.04
7822326Hepatobiliary imaging                             A   0.84   0.34     0.30     0.34     0.30     0.04   1.22   1.18   1.22   1.18  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78230  Salivary gland imaging                            A   0.45   4.40     4.29     4.40NA   4.29 NA  0.06   4.91   4.80   4.91   4.80  1XXX.00.00.0000000             25.5217 090 99      9.49   9.49   0.10
78230TCSalivary gland imaging                            A   0.00   4.22     4.12     4.22NA   4.12 NA  0.03   4.25   4.15   4.25   4.15  1XXX.00.00.0000000             25.5217 010 99      9.31   9.31   0.07
7823026Salivary gland imaging                            A   0.45   0.18     0.17     0.18     0.17     0.03   0.66   0.65   0.66   0.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78231  Serial salivary imaging                           A   0.52   3.24     2.87     3.24NA   2.87 NA  0.04   3.80   3.43   3.80   3.43  1XXX.00.00.0000000             25.5217 090 99      9.49   9.49   0.10
78231TCSerial salivary imaging                           A   0.00   3.03     2.67     3.03NA   2.67 NA  0.03   3.06   2.70   3.06   2.70  1XXX.00.00.0000000             25.5217 010 99      9.28   9.28   0.09
7823126Serial salivary imaging                           A   0.52   0.21     0.20     0.21     0.20     0.01   0.74   0.73   0.74   0.73  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78232  Salivary gland function exam                      A   0.47   2.94     2.13     2.94NA   2.13 NA  0.06   3.47   2.66   3.47   2.66  1XXX.00.00.0000000             25.5217 090 99      9.43   9.43   0.13
78232TCSalivary gland function exam                      A   0.00   2.79     2.05     2.79NA   2.05 NA  0.03   2.82   2.08   2.82   2.08  1XXX.00.00.0000000             25.5217 010 99      9.28   9.28   0.10
7823226Salivary gland function exam                      A   0.47   0.15     0.08     0.15     0.08     0.03   0.65   0.58   0.65   0.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78258  Esophageal motility study                         A   0.74   5.94     5.70     5.94NA   5.70 NA  0.06   6.74   6.50   6.74   6.50  1XXX.00.00.0000000             25.5217 090 99      9.64   9.64   0.08
78258TCEsophageal motility study                         A   0.00   5.63     5.43     5.63NA   5.43 NA  0.03   5.66   5.46   5.66   5.46  1XXX.00.00.0000000             25.5217 010 99      9.33   9.33   0.05
7825826Esophageal motility study                         A   0.74   0.31     0.27     0.31     0.27     0.03   1.08   1.04   1.08   1.04  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78261  Gastric mucosa imaging                            A   0.69   6.62     6.31     6.62NA   6.31 NA  0.07   7.38   7.07   7.38   7.07  1XXX.00.00.0000000             25.5217 090 99      9.62   9.62   0.08
78261TCGastric mucosa imaging                            A   0.00   6.33     6.05     6.33NA   6.05 NA  0.03   6.36   6.08   6.36   6.08  1XXX.00.00.0000000             25.5217 010 99      9.33   9.33   0.04
7826126Gastric mucosa imaging                            A   0.69   0.29     0.26     0.29     0.26     0.04   1.02   0.99   1.02   0.99  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78262  Gastroesophageal reflux exam                      A   0.68   6.52     6.19     6.52NA   6.19 NA  0.04   7.24   6.91   7.24   6.91  1XXX.00.00.0000000             25.5217 090 99      9.60   9.60   0.05
78262TCGastroesophageal reflux exam                      A   0.00   6.25     5.95     6.25NA   5.95 NA  0.03   6.28   5.98   6.28   5.98  1XXX.00.00.0000000             25.5217 010 99      9.33   9.33   0.04
7826226Gastroesophageal reflux exam                      A   0.68   0.27     0.24     0.27     0.24     0.01   0.96   0.93   0.96   0.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78264  Gastric emptying study                            A   0.78   7.60     7.29     7.60NA   7.29 NA  0.07   8.45   8.14   8.45   8.14  1XXX.00.00.0000000             25.5217 090 99      9.66   9.66   0.08
78264TCGastric emptying study                            A   0.00   7.28     7.01     7.28NA   7.01 NA  0.03   7.31   7.04   7.31   7.04  1XXX.00.00.0000000             25.5217 010 99      9.34   9.34   0.04
7826426Gastric emptying study                            A   0.78   0.32     0.28     0.32     0.28     0.04   1.14   1.10   1.14   1.10  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78267  Breath tst attain/anal c-14                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
78268  Breath test analysis c-14                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
78270  Vit B-12 absorption exam                          A   0.20   2.18     2.08     2.18NA   2.08 NA  0.02   2.40   2.30   2.40   2.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78270TCVit B-12 absorption exam                          A   0.00   2.10     2.00     2.10NA   2.00 NA  0.01   2.11   2.01   2.11   2.01  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7827026Vit B-12 absorption exam                          A   0.20   0.08     0.08     0.08     0.08     0.01   0.29   0.29   0.29   0.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78271  Vit b-12 absrp exam int fac                       A   0.20   2.31     2.30     2.31NA   2.30 NA  0.02   2.53   2.52   2.53   2.52  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78271TCVit b-12 absrp exam int fac                       A   0.00   2.23     2.21     2.23NA   2.21 NA  0.01   2.24   2.22   2.24   2.22  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7827126Vit b-12 absrp exam int fac                       A   0.20   0.08     0.09     0.08     0.09     0.01   0.29   0.30   0.29   0.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78272  Vit b-12 absorp combined                          A   0.27   2.38     2.21     2.38NA   2.21 NA  0.04   2.69   2.52   2.69   2.52  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78272TCVit b-12 absorp combined                          A   0.00   2.28     2.10     2.28NA   2.10 NA  0.03   2.31   2.13   2.31   2.13  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7827226Vit b-12 absorp combined                          A   0.27   0.10     0.11     0.10     0.11     0.01   0.38   0.39   0.38   0.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78278  Acute GI blood loss imaging                       A   0.99   9.13     8.79     9.13NA   8.79 NA  0.08  10.20   9.86  10.20   9.86  1XXX.00.00.0000000             25.5217 090 99      9.74   9.74   0.08
78278TCAcute GI blood loss imaging                       A   0.00   8.73     8.44     8.73NA   8.44 NA  0.03   8.76   8.47   8.76   8.47  1XXX.00.00.0000000             25.5217 010 99      9.34   9.34   0.03
7827826Acute GI blood loss imaging                       A   0.99   0.40     0.35     0.40     0.35     0.05   1.44   1.39   1.44   1.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78282  GI protein loss exam                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      9.53   9.53   0.04
78282TCGI protein loss exam                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99      9.37   9.37   0.01
7828226GI protein loss exam                              A   0.38   0.16     0.14     0.16     0.14     0.03   0.57   0.55   0.57   0.55  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78290  Meckels divert exam                               A   0.68   8.75     8.69     8.75NA   8.69 NA  0.07   9.50   9.44   9.50   9.44  1XXX.00.00.0000000             25.5217 090 99      9.62   9.62   0.07
78290TCMeckels divert exam                               A   0.00   8.47     8.45     8.47NA   8.45 NA  0.03   8.50   8.48   8.50   8.48  1XXX.00.00.0000000             25.5217 010 99      9.34   9.34   0.03
7829026Meckels divert exam                               A   0.68   0.28     0.24     0.28     0.24     0.04   1.00   0.96   1.00   0.96  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78291  Leveen/shunt patency exam                         A   0.88   6.50     6.29     6.50NA   6.29 NA  0.08   7.46   7.25   7.46   7.25  1XXX.00.00.0000000             25.5217 090 99      9.68   9.68   0.10
78291TCLeveen/shunt patency exam                         A   0.00   6.15     5.99     6.15NA   5.99 NA  0.03   6.18   6.02   6.18   6.02  1XXX.00.00.0000000             25.5217 010 99      9.33   9.33   0.05
7829126Leveen/shunt patency exam                         A   0.88   0.35     0.30     0.35     0.30     0.05   1.28   1.23   1.28   1.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78299  GI nuclear procedure                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78299TCGI nuclear procedure                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7829926GI nuclear procedure                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78300  Bone imaging limited area                         A   0.62   4.53     4.37     4.53NA   4.37 NA  0.06   5.21   5.05   5.21   5.05  1XXX.00.00.0000000             25.5217 090 99      9.78   9.78   0.10
78300TCBone imaging limited area                         A   0.00   4.27     4.14     4.27NA   4.14 NA  0.03   4.30   4.17   4.30   4.17  1XXX.00.00.0000000             25.5217 010 99      9.52   9.52   0.07
7830026Bone imaging limited area                         A   0.62   0.26     0.23     0.26     0.23     0.03   0.91   0.88   0.91   0.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78305  Bone imaging multiple areas                       A   0.83   5.97     5.73     5.97NA   5.73 NA  0.07   6.87   6.63   6.87   6.63  1XXX.00.00.0000000             25.5217 090 99      9.87   9.87   0.09
78305TCBone imaging multiple areas                       A   0.00   5.64     5.43     5.64NA   5.43 NA  0.03   5.67   5.46   5.67   5.46  1XXX.00.00.0000000             25.5217 010 99      9.54   9.54   0.05
7830526Bone imaging multiple areas                       A   0.83   0.33     0.30     0.33     0.30     0.04   1.20   1.17   1.20   1.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78306  Bone imaging whole body                           A   0.86   6.56     6.15     6.56NA   6.15 NA  0.07   7.49   7.08   7.49   7.08  1XXX.00.00.0000000             25.5217 090 99      9.89   9.89   0.09
78306TCBone imaging whole body                           A   0.00   6.21     5.85     6.21NA   5.85 NA  0.03   6.24   5.88   6.24   5.88  1XXX.00.00.0000000             25.5217 010 99      9.54   9.54   0.05
7830626Bone imaging whole body                           A   0.86   0.35     0.30     0.35     0.30     0.04   1.25   1.20   1.25   1.20  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78315  Bone imaging 3 phase                              A   1.02   9.10     8.75     9.10NA   8.75 NA  0.08  10.20   9.85  10.20   9.85  1XXX.00.00.0000000             25.5217 090 99      9.96   9.96   0.08
78315TCBone imaging 3 phase                              A   0.00   8.69     8.39     8.69NA   8.39 NA  0.03   8.72   8.42   8.72   8.42  1XXX.00.00.0000000             25.5217 010 99      9.55   9.55   0.03
7831526Bone imaging 3 phase                              A   1.02   0.41     0.36     0.41     0.36     0.05   1.48   1.43   1.48   1.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78320  Bone imaging (3D)                                 A   1.04   6.09     5.33     6.09NA   5.33 NA  0.08   7.21   6.45   7.21   6.45  1XXX.00.00.0000000             25.5217 090 99      9.95   9.95   0.10
78320TCBone imaging (3D)                                 A   0.00   5.68     4.99     5.68NA   4.99 NA  0.03   5.71   5.02   5.71   5.02  1XXX.00.00.0000000             25.5217 010 99      9.54   9.54   0.05
7832026Bone imaging (3D)                                 A   1.04   0.41     0.34     0.41     0.34     0.05   1.50   1.43   1.50   1.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78350  Bone mineral single photon                        N+  0.22   0.74     0.68     0.74NA   0.68 NA  0.02   0.98   0.92   0.98   0.92  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
78350TCBone mineral single photon                        N+  0.00   0.65     0.58     0.65NA   0.58 NA  0.01   0.66   0.59   0.66   0.59  1XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
7835026Bone mineral single photon                        N+  0.22   0.09     0.10     0.09     0.10     0.01   0.32   0.33   0.32   0.33  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
78351  Bone mineral dual photon                          N+  0.30   0.13     0.13     0.13     0.13     0.01   0.44   0.44   0.44   0.44  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
78399  Musculoskeletal nuclear exam                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78399TCMusculoskeletal nuclear exam                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7839926Musculoskeletal nuclear exam                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78414  Non-imaging heart function                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78414TCNon-imaging heart function                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7841426Non-imaging heart function                        A   0.45   0.18     0.20     0.18     0.20     0.03   0.66   0.68   0.66   0.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78428  Cardiac shunt imaging                             A   0.78   4.89     4.38     4.89NA   4.38 NA  0.06   5.73   5.22   5.73   5.22  1XXX.00.00.0000000             25.5217 090 99     11.69  11.69   0.10
78428TCCardiac shunt imaging                             A   0.00   4.54     4.10     4.54NA   4.10 NA  0.03   4.57   4.13   4.57   4.13  1XXX.00.00.0000000             25.5217 010 99     11.34  11.34   0.07
7842826Cardiac shunt imaging                             A   0.78   0.35     0.28     0.35     0.28     0.03   1.16   1.09   1.16   1.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78445  Vascular flow imaging                             A   0.49   4.53     4.32     4.53NA   4.32 NA  0.04   5.06   4.85   5.06   4.85  1XXX.00.00.0000000             25.5217 090 99      7.99   7.99   0.06
78445TCVascular flow imaging                             A   0.00   4.34     4.16     4.34NA   4.16 NA  0.03   4.37   4.19   4.37   4.19  1XXX.00.00.0000000             25.5217 010 99      7.80   7.80   0.05
7844526Vascular flow imaging                             A   0.49   0.19     0.16     0.19     0.16     0.01   0.69   0.66   0.69   0.66  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78451  Ht muscle image spect sing                        A   1.38   8.62     8.62     8.62NA   8.62 NA  0.08  10.08  10.08  10.08  10.08  1XXX.00.00.0000000             25.5217 090 99     30.18  30.18   0.16
78451TCHt muscle image spect sing                        A   0.00   8.10     8.10     8.10NA   8.10 NA  0.03   8.13   8.13   8.13   8.13  1XXX.00.00.0000000             25.5217 010 99     29.66  29.66   0.11
7845126Ht muscle image spect sing                        A   1.38   0.52     0.52     0.52     0.52     0.05   1.95   1.95   1.95   1.95  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78452  Ht muscle image spect mult                        A   1.62  12.40    12.40    12.40NA  12.40 NA  0.09  14.11  14.11  14.11  14.11  1XXX.00.00.0000000             25.5217 090 99     30.29  30.29   0.15
78452TCHt muscle image spect mult                        A   0.00  11.78    11.78    11.78NA  11.78 NA  0.04  11.82  11.82  11.82  11.82  1XXX.00.00.0000000             25.5217 010 99     29.67  29.67   0.10
7845226Ht muscle image spect mult                        A   1.62   0.62     0.62     0.62     0.62     0.05   2.29   2.29   2.29   2.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78453  Ht muscle image planar sing                       A   1.00   7.58     7.58     7.58NA   7.58 NA  0.08   8.66   8.66   8.66   8.66  1XXX.00.00.0000000             25.5217 090 99     30.02  30.02   0.17
78453TCHt muscle image planar sing                       A   0.00   7.21     7.21     7.21NA   7.21 NA  0.03   7.24   7.24   7.24   7.24  1XXX.00.00.0000000             25.5217 010 99     29.65  29.65   0.12
7845326Ht muscle image planar sing                       A   1.00   0.37     0.37     0.37     0.37     0.05   1.42   1.42   1.42   1.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78454  Ht musc image planar mult                         A   1.34  11.08    11.08    11.08NA  11.08 NA  0.09  12.51  12.51  12.51  12.51  1XXX.00.00.0000000             25.5217 090 99     30.16  30.16   0.16
78454TCHt musc image planar mult                         A   0.00  10.58    10.58    10.58NA  10.58 NA  0.04  10.62  10.62  10.62  10.62  1XXX.00.00.0000000             25.5217 010 99     29.66  29.66   0.11
7845426Ht musc image planar mult                         A   1.34   0.50     0.50     0.50     0.50     0.05   1.89   1.89   1.89   1.89  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78456  Acute venous thrombus image                       A   1.00   9.40     8.79     9.40NA   8.79 NA  0.06  10.46   9.85  10.46   9.85  1XXX.00.00.0099999             25.5217 090 99      8.29   8.29   0.06
78456TCAcute venous thrombus image                       A   0.00   8.93     8.42     8.93NA   8.42 NA  0.03   8.96   8.45   8.96   8.45  1XXX.00.00.0099999             25.5217 090 99      7.82   7.82   0.03
7845626Acute venous thrombus image                       A   1.00   0.47     0.37     0.47     0.37     0.03   1.50   1.40   1.50   1.40  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
78457  Venous thrombosis imaging                         A   0.77   4.93     4.70     4.93NA   4.70 NA  0.07   5.77   5.54   5.77   5.54  1XXX.00.00.0000000             25.5217 090 99      8.11   8.11   0.09
78457TCVenous thrombosis imaging                         A   0.00   4.62     4.42     4.62NA   4.42 NA  0.03   4.65   4.45   4.65   4.45  1XXX.00.00.0000000             25.5217 010 99      7.80   7.80   0.05
7845726Venous thrombosis imaging                         A   0.77   0.31     0.28     0.31     0.28     0.04   1.12   1.09   1.12   1.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78458  Ven thrombosis images bilat                       A   0.90   4.82     4.08     4.82NA   4.08 NA  0.08   5.80   5.06   5.80   5.06  1XXX.00.00.0002000             25.5217 090 99      8.11   8.11   0.10
78458TCVen thrombosis images bilat                       A   0.00   4.51     3.87     4.51NA   3.87 NA  0.03   4.54   3.90   4.54   3.90  1XXX.00.00.0002000             25.5217 010 99      7.80   7.80   0.05
7845826Ven thrombosis images bilat                       A   0.90   0.31     0.21     0.31     0.21     0.05   1.26   1.16   1.26   1.16  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
78459  Heart muscle imaging (PET)                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     44.00  44.00   0.11
78459TCHeart muscle imaging (PET)                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     43.38  43.38   0.01
7845926Heart muscle imaging (PET)                        A   1.50   0.62     0.45     0.62     0.45     0.10   2.22   2.05   2.22   2.05  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78466  Heart infarct image                               A   0.69   4.58     4.18     4.58NA   4.18 NA  0.06   5.33   4.93   5.33   4.93  1XXX.00.00.0000000             25.5217 090 99     11.65  11.65   0.11
78466TCHeart infarct image                               A   0.00   4.27     3.92     4.27NA   3.92 NA  0.03   4.30   3.95   4.30   3.95  1XXX.00.00.0000000             25.5217 010 99     11.34  11.34   0.08
7846626Heart infarct image                               A   0.69   0.31     0.26     0.31     0.26     0.03   1.03   0.98   1.03   0.98  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78468  Heart infarct image (ef)                          A   0.80   5.61     4.87     5.61NA   4.87 NA  0.06   6.47   5.73   6.47   5.73  1XXX.00.00.0000000             25.5217 090 99     11.73  11.73   0.10
78468TCHeart infarct image (ef)                          A   0.00   5.23     4.56     5.23NA   4.56 NA  0.03   5.26   4.59   5.26   4.59  1XXX.00.00.0000000             25.5217 010 99     11.35  11.35   0.07
7846826Heart infarct image (ef)                          A   0.80   0.38     0.31     0.38     0.31     0.03   1.21   1.14   1.21   1.14  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78469  Heart infarct image (3D)                          A   0.92   6.64     6.09     6.64NA   6.09 NA  0.06   7.62   7.07   7.62   7.07  1XXX.00.00.0000000             25.5217 090 99     11.81  11.81   0.09
78469TCHeart infarct image (3D)                          A   0.00   6.19     5.69     6.19NA   5.69 NA  0.03   6.22   5.72   6.22   5.72  1XXX.00.00.0000000             25.5217 010 99     11.36  11.36   0.06
7846926Heart infarct image (3D)                          A   0.92   0.45     0.40     0.45     0.40     0.03   1.40   1.35   1.40   1.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78472  Gated heart planar single                         A   0.98   6.39     5.56     6.39NA   5.56 NA  0.07   7.44   6.61   7.44   6.61  1XXX.00.00.0000000             25.5217 090 99     11.79  11.79   0.10
78472TCGated heart planar single                         A   0.00   5.96     5.21     5.96NA   5.21 NA  0.03   5.99   5.24   5.99   5.24  1XXX.00.00.0000000             25.5217 010 99     11.36  11.36   0.06
7847226Gated heart planar single                         A   0.98   0.43     0.35     0.43     0.35     0.04   1.45   1.37   1.45   1.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78473  Gated heart multiple                              A   1.47   8.28     6.89     8.28NA   6.89 NA  0.08   9.83   8.44   9.83   8.44  1XXX.00.00.0000000             25.5217 090 99     12.04  12.04   0.09
78473TCGated heart multiple                              A   0.00   7.61     6.34     7.61NA   6.34 NA  0.03   7.64   6.37   7.64   6.37  1XXX.00.00.0000000             25.5217 010 99     11.37  11.37   0.04
7847326Gated heart multiple                              A   1.47   0.67     0.55     0.67     0.55     0.05   2.19   2.07   2.19   2.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78481  Heart first pass single                           A   0.98   5.19     4.21     5.19NA   4.21 NA  0.04   6.21   5.23   6.21   5.23  1XXX.00.00.0000000             25.5217 090 99     11.87  11.87   0.05
78481TCHeart first pass single                           A   0.00   4.71     3.83     4.71NA   3.83 NA  0.01   4.72   3.84   4.72   3.84  1XXX.00.00.0000000             25.5217 010 99     11.39  11.39   0.02
7848126Heart first pass single                           A   0.98   0.48     0.38     0.48     0.38     0.03   1.49   1.39   1.49   1.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78483  Heart first pass multiple                         A   1.47   7.06     5.55     7.06NA   5.55 NA  0.08   8.61   7.10   8.61   7.10  1XXX.00.00.0000000             25.5217 090 99     12.09  12.09   0.10
78483TCHeart first pass multiple                         A   0.00   6.33     4.98     6.33NA   4.98 NA  0.03   6.36   5.01   6.36   5.01  1XXX.00.00.0000000             25.5217 010 99     11.36  11.36   0.05
7848326Heart first pass multiple                         A   1.47   0.73     0.57     0.73     0.57     0.05   2.25   2.09   2.25   2.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78491  Heart image (pet) single                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     44.03  44.03   0.11
78491TCHeart image (pet) single                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     43.38  43.38   0.01
7849126Heart image (pet) single                          A   1.50   0.65     0.49     0.65     0.49     0.10   2.25   2.09   2.25   2.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78492  Heart image (pet) multiple                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     44.24  44.24   0.13
78492TCHeart image (pet) multiple                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     43.38  43.38   0.01
7849226Heart image (pet) multiple                        A   1.87   0.86     0.66     0.86     0.66     0.12   2.85   2.65   2.85   2.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78494  Heart image spect                                 A   1.19   6.66     5.59     6.66NA   5.59 NA  0.07   7.92   6.85   7.92   6.85  1XXX.00.00.0000000             25.5217 090 99     11.91  11.91   0.10
78494TCHeart image spect                                 A   0.00   6.11     5.12     6.11NA   5.12 NA  0.03   6.14   5.15   6.14   5.15  1XXX.00.00.0000000             25.5217 010 99     11.36  11.36   0.06
7849426Heart image spect                                 A   1.19   0.55     0.47     0.55     0.47     0.04   1.78   1.70   1.78   1.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78496  Heart first pass add-on                           A   0.50   1.88     0.74     1.88NA   0.74 NA  0.02   2.40   1.26   2.40   1.26  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78496TCHeart first pass add-on                           A   0.00   1.64     0.55     1.64NA   0.55 NA  0.01   1.65   0.56   1.65   0.56  1ZZZ.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7849626Heart first pass add-on                           A   0.50   0.24     0.19     0.24     0.19     0.01   0.75   0.70   0.75   0.70  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78499  Cardiovascular nuclear exam                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78499TCCardiovascular nuclear exam                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7849926Cardiovascular nuclear exam                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78580  Lung perfusion imaging                            A   0.74   5.48     5.15     5.48NA   5.15 NA  0.06   6.28   5.95   6.28   5.95  1XXX.00.00.0000000             25.5217 090 99      7.97   7.97   0.07
78580TCLung perfusion imaging                            A   0.00   5.18     4.90     5.18NA   4.90 NA  0.03   5.21   4.93   5.21   4.93  1XXX.00.00.0000000             25.5217 010 99      7.67   7.67   0.04
7858026Lung perfusion imaging                            A   0.74   0.30     0.25     0.30     0.25     0.03   1.07   1.02   1.07   1.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78584  Lung V/Q image single breath                      A   0.99   3.44     3.03     3.44NA   3.03 NA  0.08   4.51   4.10   4.51   4.10  1XXX.00.00.0000000             25.5217 090 99     12.82  12.82   0.17
78584TCLung V/Q image single breath                      A   0.00   3.03     2.66     3.03NA   2.66 NA  0.03   3.06   2.69   3.06   2.69  1XXX.00.00.0000000             25.5217 010 99     12.41  12.41   0.12
7858426Lung V/Q image single breath                      A   0.99   0.41     0.37     0.41     0.37     0.05   1.45   1.41   1.45   1.41  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78585  Lung V/Q imaging                                  A   1.09   9.27     8.79     9.27NA   8.79 NA  0.08  10.44   9.96  10.44   9.96  1XXX.00.00.0000000             25.5217 090 99     12.93  12.93   0.09
78585TCLung V/Q imaging                                  A   0.00   8.83     8.41     8.83NA   8.41 NA  0.03   8.86   8.44   8.86   8.44  1XXX.00.00.0000000             25.5217 010 99     12.49  12.49   0.04
7858526Lung V/Q imaging                                  A   1.09   0.44     0.38     0.44     0.38     0.05   1.58   1.52   1.58   1.52  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78586  Aerosol lung image single                         A   0.40   4.49     4.33     4.49NA   4.33 NA  0.04   4.93   4.77   4.93   4.77  1XXX.00.00.0000000             25.5217 090 99      7.83   7.83   0.06
78586TCAerosol lung image single                         A   0.00   4.32     4.18     4.32NA   4.18 NA  0.03   4.35   4.21   4.35   4.21  1XXX.00.00.0000000             25.5217 010 99      7.66   7.66   0.05
7858626Aerosol lung image single                         A   0.40   0.17     0.15     0.17     0.15     0.01   0.58   0.56   0.58   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78587  Aerosol lung image multiple                       A   0.49   5.62     5.35     5.62NA   5.35 NA  0.06   6.17   5.90   6.17   5.90  1XXX.00.00.0000000             25.5217 090 99      7.86   7.86   0.07
78587TCAerosol lung image multiple                       A   0.00   5.43     5.19     5.43NA   5.19 NA  0.03   5.46   5.22   5.46   5.22  1XXX.00.00.0000000             25.5217 010 99      7.67   7.67   0.04
7858726Aerosol lung image multiple                       A   0.49   0.19     0.16     0.19     0.16     0.03   0.71   0.68   0.71   0.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78588  Perfusion lung image                              A   1.09   8.95     8.87     8.95NA   8.87 NA  0.08  10.12  10.04  10.12  10.04  1XXX.00.00.0000000             25.5217 090 99     12.93  12.93   0.09
78588TCPerfusion lung image                              A   0.00   8.51     8.48     8.51NA   8.48 NA  0.03   8.54   8.51   8.54   8.51  1XXX.00.00.0000000             25.5217 010 99     12.49  12.49   0.04
7858826Perfusion lung image                              A   1.09   0.44     0.39     0.44     0.39     0.05   1.58   1.53   1.58   1.53  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78591  Vent image 1 breath 1 proj                        A   0.40   4.54     4.36     4.54NA   4.36 NA  0.04   4.98   4.80   4.98   4.80  1XXX.00.00.0000000             25.5217 090 99      7.83   7.83   0.06
78591TCVent image 1 breath 1 proj                        A   0.00   4.37     4.21     4.37NA   4.21 NA  0.03   4.40   4.24   4.40   4.24  1XXX.00.00.0000000             25.5217 010 99      7.66   7.66   0.05
7859126Vent image 1 breath 1 proj                        A   0.40   0.17     0.15     0.17     0.15     0.01   0.58   0.56   0.58   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78593  Vent image 1 proj gas                             A   0.49   5.24     4.96     5.24NA   4.96 NA  0.06   5.79   5.51   5.79   5.51  1XXX.00.00.0000000             25.5217 090 99      7.87   7.87   0.08
78593TCVent image 1 proj gas                             A   0.00   5.04     4.79     5.04NA   4.79 NA  0.03   5.07   4.82   5.07   4.82  1XXX.00.00.0000000             25.5217 010 99      7.67   7.67   0.05
7859326Vent image 1 proj gas                             A   0.49   0.20     0.17     0.20     0.17     0.03   0.72   0.69   0.72   0.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78594  Vent image mult proj gas                          A   0.53   5.81     5.16     5.81NA   5.16 NA  0.06   6.40   5.75   6.40   5.75  1XXX.00.00.0000000             25.5217 090 99      7.87   7.87   0.07
78594TCVent image mult proj gas                          A   0.00   5.61     5.00     5.61NA   5.00 NA  0.03   5.64   5.03   5.64   5.03  1XXX.00.00.0000000             25.5217 010 99      7.67   7.67   0.04
7859426Vent image mult proj gas                          A   0.53   0.20     0.16     0.20     0.16     0.03   0.76   0.72   0.76   0.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78596  Lung differential function                        A   1.27   9.68     9.03     9.68NA   9.03 NA  0.07  11.02  10.37  11.02  10.37  1XXX.00.00.0000000             25.5217 090 99     12.98  12.98   0.08
78596TCLung differential function                        A   0.00   9.19     8.60     9.19NA   8.60 NA  0.03   9.22   8.63   9.22   8.63  1XXX.00.00.0000000             25.5217 010 99     12.49  12.49   0.04
7859626Lung differential function                        A   1.27   0.49     0.43     0.49     0.43     0.04   1.80   1.74   1.80   1.74  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78599  Respiratory nuclear exam                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78599TCRespiratory nuclear exam                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7859926Respiratory nuclear exam                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78600  Brain image < 4 views                             A   0.44   4.83     4.58     4.83NA   4.58 NA  0.04   5.31   5.06   5.31   5.06  1XXX.00.00.0000000             25.5217 090 99      9.54   9.54   0.07
78600TCBrain image < 4 views                             A   0.00   4.64     4.42     4.64NA   4.42 NA  0.03   4.67   4.45   4.67   4.45  1XXX.00.00.0000000             25.5217 010 99      9.35   9.35   0.06
7860026Brain image < 4 views                             A   0.44   0.19     0.16     0.19     0.16     0.01   0.64   0.61   0.64   0.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78601  Brain image w/flow < 4 views                      A   0.51   5.73     5.44     5.73NA   5.44 NA  0.06   6.30   6.01   6.30   6.01  1XXX.00.00.0000000             25.5217 090 99     23.44  23.44   0.16
78601TCBrain image w/flow < 4 views                      A   0.00   5.53     5.26     5.53NA   5.26 NA  0.03   5.56   5.29   5.56   5.29  1XXX.00.00.0000000             25.5217 010 99     23.24  23.24   0.13
7860126Brain image w/flow < 4 views                      A   0.51   0.20     0.18     0.20     0.18     0.03   0.74   0.72   0.74   0.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78605  Brain image 4+ views                              A   0.53   5.24     4.91     5.24NA   4.91 NA  0.06   5.83   5.50   5.83   5.50  1XXX.00.00.0000000             25.5217 090 99      9.59   9.59   0.09
78605TCBrain image 4+ views                              A   0.00   5.01     4.71     5.01NA   4.71 NA  0.03   5.04   4.74   5.04   4.74  1XXX.00.00.0000000             25.5217 010 99      9.36   9.36   0.06
7860526Brain image 4+ views                              A   0.53   0.23     0.20     0.23     0.20     0.03   0.79   0.76   0.79   0.76  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78606  Brain image w/flow 4 + views                      A   0.64   8.88     8.75     8.88NA   8.75 NA  0.04   9.56   9.43   9.56   9.43  1XXX.00.00.0000000             25.5217 090 99     23.54  23.54   0.09
78606TCBrain image w/flow 4 + views                      A   0.00   8.62     8.52     8.62NA   8.52 NA  0.03   8.65   8.55   8.65   8.55  1XXX.00.00.0000000             25.5217 010 99     23.28  23.28   0.08
7860626Brain image w/flow 4 + views                      A   0.64   0.26     0.23     0.26     0.23     0.01   0.91   0.88   0.91   0.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78607  Brain imaging (3D)                                A   1.23   9.42     8.70     9.42NA   8.70 NA  0.08  10.73  10.01  10.73  10.01  1XXX.00.00.0000000             25.5217 090 99     23.77  23.77   0.13
78607TCBrain imaging (3D)                                A   0.00   8.94     8.31     8.94NA   8.31 NA  0.03   8.97   8.34   8.97   8.34  1XXX.00.00.0000000             25.5217 010 99     23.29  23.29   0.08
7860726Brain imaging (3D)                                A   1.23   0.48     0.39     0.48     0.39     0.05   1.76   1.67   1.76   1.67  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78608  Brain imaging (PET)                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     41.40  41.40   0.12
78608TCBrain imaging (PET)                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     40.82  40.82   0.01
7860826Brain imaging (PET)                               A   1.50   0.58     0.48     0.58     0.48     0.11   2.19   2.09   2.19   2.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78609  Brain imaging (PET)                               N+  1.50   0.63     0.66     0.63NA   0.66 NA  0.10   2.23   2.26   2.23   2.26  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
78609TCBrain imaging (PET)                               N   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
7860926Brain imaging (PET)                               N+  1.50   0.63     0.66     0.63     0.66     0.10   2.23   2.26   2.23   2.26  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
78610  Brain flow imaging only                           A   0.30   4.90     4.49     4.90NA   4.49 NA  0.04   5.24   4.83   5.24   4.83  1XXX.00.00.0000000             25.5217 090 99      9.48   9.48   0.07
78610TCBrain flow imaging only                           A   0.00   4.77     4.38     4.77NA   4.38 NA  0.03   4.80   4.41   4.80   4.41  1XXX.00.00.0000000             25.5217 010 99      9.35   9.35   0.06
7861026Brain flow imaging only                           A   0.30   0.13     0.11     0.13     0.11     0.01   0.44   0.42   0.44   0.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78630  Cerebrospinal fluid scan                          A   0.68   9.20     8.87     9.20NA   8.87 NA  0.06   9.94   9.61   9.94   9.61  1XXX.00.00.0000000             25.5217 090 99     23.56  23.56   0.11
78630TCCerebrospinal fluid scan                          A   0.00   8.92     8.63     8.92NA   8.63 NA  0.03   8.95   8.66   8.95   8.66  1XXX.00.00.0000000             25.5217 010 99     23.28  23.28   0.08
7863026Cerebrospinal fluid scan                          A   0.68   0.28     0.24     0.28     0.24     0.03   0.99   0.95   0.99   0.95  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78635  CSF ventriculography                              A   0.61   8.83     8.87     8.83NA   8.87 NA  0.04   9.48   9.52   9.48   9.52  1XXX.00.00.0000000             25.5217 090 99     23.54  23.54   0.09
78635TCCSF ventriculography                              A   0.00   8.57     8.64     8.57NA   8.64 NA  0.03   8.60   8.67   8.60   8.67  1XXX.00.00.0000000             25.5217 010 99     23.28  23.28   0.08
7863526CSF ventriculography                              A   0.61   0.26     0.23     0.26     0.23     0.01   0.88   0.85   0.88   0.85  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78645  CSF shunt evaluation                              A   0.57   8.72     8.52     8.72NA   8.52 NA  0.06   9.35   9.15   9.35   9.15  1XXX.00.00.0000000             25.5217 090 99      9.61   9.61   0.06
78645TCCSF shunt evaluation                              A   0.00   8.49     8.33     8.49NA   8.33 NA  0.03   8.52   8.36   8.52   8.36  1XXX.00.00.0000000             25.5217 010 99      9.38   9.38   0.03
7864526CSF shunt evaluation                              A   0.57   0.23     0.19     0.23     0.19     0.03   0.83   0.79   0.83   0.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78647  Cerebrospinal fluid scan                          A   0.90   9.30     8.80     9.30NA   8.80 NA  0.08  10.28   9.78  10.28   9.78  1XXX.00.00.0000000             25.5217 090 99     23.64  23.64   0.13
78647TCCerebrospinal fluid scan                          A   0.00   8.95     8.51     8.95NA   8.51 NA  0.03   8.98   8.54   8.98   8.54  1XXX.00.00.0000000             25.5217 010 99     23.29  23.29   0.08
7864726Cerebrospinal fluid scan                          A   0.90   0.35     0.29     0.35     0.29     0.05   1.30   1.24   1.30   1.24  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78650  CSF leakage imaging                               A   0.61   9.05     8.73     9.05NA   8.73 NA  0.07   9.73   9.41   9.73   9.41  1XXX.00.00.0000000             25.5217 090 99     23.52  23.52   0.12
78650TCCSF leakage imaging                               A   0.00   8.81     8.53     8.81NA   8.53 NA  0.03   8.84   8.56   8.84   8.56  1XXX.00.00.0000000             25.5217 010 99     23.28  23.28   0.08
7865026CSF leakage imaging                               A   0.61   0.24     0.20     0.24     0.20     0.04   0.89   0.85   0.89   0.85  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78660  Nuclear exam of tear flow                         A   0.53   4.64     4.65     4.64NA   4.65 NA  0.06   5.23   5.24   5.23   5.24  1XXX.00.00.0000000             25.5217 090 99      9.58   9.58   0.09
78660TCNuclear exam of tear flow                         A   0.00   4.41     4.43     4.41NA   4.43 NA  0.03   4.44   4.46   4.44   4.46  1XXX.00.00.0000000             25.5217 010 99      9.35   9.35   0.06
7866026Nuclear exam of tear flow                         A   0.53   0.23     0.22     0.23     0.22     0.03   0.79   0.78   0.79   0.78  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78699  Nervous system nuclear exam                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78699TCNervous system nuclear exam                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7869926Nervous system nuclear exam                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78700  Kidney imaging morphol                            A   0.45   4.70     4.41     4.70NA   4.41 NA  0.06   5.21   4.92   5.21   4.92  1XXX.00.00.0000000             25.5217 090 99     12.70  12.70   0.11
78700TCKidney imaging morphol                            A   0.00   4.51     4.25     4.51NA   4.25 NA  0.03   4.54   4.28   4.54   4.28  1XXX.00.00.0000000             25.5217 010 99     12.51  12.51   0.08
7870026Kidney imaging morphol                            A   0.45   0.19     0.16     0.19     0.16     0.03   0.67   0.64   0.67   0.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78701  Kidney imaging with flow                          A   0.49   5.74     5.44     5.74NA   5.44 NA  0.06   6.29   5.99   6.29   5.99  1XXX.00.00.0000000             25.5217 090 99     12.73  12.73   0.10
78701TCKidney imaging with flow                          A   0.00   5.54     5.27     5.54NA   5.27 NA  0.03   5.57   5.30   5.57   5.30  1XXX.00.00.0000000             25.5217 010 99     12.53  12.53   0.07
7870126Kidney imaging with flow                          A   0.49   0.20     0.17     0.20     0.17     0.03   0.72   0.69   0.72   0.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78707  K flow/funct image w/o drug                       A   0.96   5.99     5.47     5.99NA   5.47 NA  0.07   7.02   6.50   7.02   6.50  1XXX.00.00.0000000             25.5217 090 99     12.91  12.91   0.11
78707TCK flow/funct image w/o drug                       A   0.00   5.61     5.15     5.61NA   5.15 NA  0.03   5.64   5.18   5.64   5.18  1XXX.00.00.0000000             25.5217 010 99     12.53  12.53   0.07
7870726K flow/funct image w/o drug                       A   0.96   0.38     0.32     0.38     0.32     0.04   1.38   1.32   1.38   1.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78708  K flow/funct image w/drug                         A   1.21   4.04     3.37     4.04NA   3.37 NA  0.08   5.33   4.66   5.33   4.66  1XXX.00.00.0000000             25.5217 090 99     12.98  12.98   0.16
78708TCK flow/funct image w/drug                         A   0.00   3.55     2.96     3.55NA   2.96 NA  0.03   3.58   2.99   3.58   2.99  1XXX.00.00.0000000             25.5217 010 99     12.49  12.49   0.11
7870826K flow/funct image w/drug                         A   1.21   0.49     0.41     0.49     0.41     0.05   1.75   1.67   1.75   1.67  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78709  K flow/funct image multiple                       A   1.41   9.33     8.95     9.33NA   8.95 NA  0.10  10.84  10.46  10.84  10.46  1XXX.00.00.0000000             25.5217 090 99     13.12  13.12   0.11
78709TCK flow/funct image multiple                       A   0.00   8.76     8.47     8.76NA   8.47 NA  0.03   8.79   8.50   8.79   8.50  1XXX.00.00.0000000             25.5217 010 99     12.55  12.55   0.04
7870926K flow/funct image multiple                       A   1.41   0.57     0.48     0.57     0.48     0.07   2.05   1.96   2.05   1.96  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78710  Kidney imaging (3D)                               A   0.66   5.88     5.05     5.88NA   5.05 NA  0.04   6.58   5.75   6.58   5.75  1XXX.00.00.0000000             25.5217 090 99     12.78  12.78   0.08
78710TCKidney imaging (3D)                               A   0.00   5.63     4.85     5.63NA   4.85 NA  0.03   5.66   4.88   5.66   4.88  1XXX.00.00.0000000             25.5217 010 99     12.53  12.53   0.07
7871026Kidney imaging (3D)                               A   0.66   0.25     0.20     0.25     0.20     0.01   0.92   0.87   0.92   0.87  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78725  Kidney function study                             A   0.38   2.61     2.49     2.61NA   2.49 NA  0.04   3.03   2.91   3.03   2.91  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78725TCKidney function study                             A   0.00   2.46     2.35     2.46NA   2.35 NA  0.03   2.49   2.38   2.49   2.38  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
7872526Kidney function study                             A   0.38   0.15     0.14     0.15     0.14     0.01   0.54   0.53   0.54   0.53  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78730  Urinary bladder retention                         A   0.15   2.04     1.80     2.04NA   1.80 NA  0.02   2.21   1.97   2.21   1.97  1ZZZ.00.00.0000000             25.5217 090 99      4.01   4.01   0.03
78730TCUrinary bladder retention                         A   0.00   1.96     1.74     1.96NA   1.74 NA  0.01   1.97   1.75   1.97   1.75  1ZZZ.00.00.0000000             25.5217 010 99      3.93   3.93   0.02
7873026Urinary bladder retention                         A   0.15   0.08     0.06     0.08     0.06     0.01   0.24   0.22   0.24   0.22  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78740  Ureteral reflux study                             A   0.57   5.91     5.88     5.91NA   5.88 NA  0.06   6.54   6.51   6.54   6.51  1XXX.00.00.0000000             25.5217 090 99     12.78  12.78   0.10
78740TCUreteral reflux study                             A   0.00   5.66     5.65     5.66NA   5.65 NA  0.03   5.69   5.68   5.69   5.68  1XXX.00.00.0000000             25.5217 010 99     12.53  12.53   0.07
7874026Ureteral reflux study                             A   0.57   0.25     0.23     0.25     0.23     0.03   0.85   0.83   0.85   0.83  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78761  Testicular imaging w/flow                         A   0.71   5.50     5.26     5.50NA   5.26 NA  0.07   6.28   6.04   6.28   6.04  1XXX.00.00.0000000             25.5217 090 99     12.82  12.82   0.11
78761TCTesticular imaging w/flow                         A   0.00   5.20     4.99     5.20NA   4.99 NA  0.03   5.23   5.02   5.23   5.02  1XXX.00.00.0000000             25.5217 010 99     12.52  12.52   0.07
7876126Testicular imaging w/flow                         A   0.71   0.30     0.27     0.30     0.27     0.04   1.05   1.02   1.05   1.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78799  Genitourinary nuclear exam                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78799TCGenitourinary nuclear exam                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7879926Genitourinary nuclear exam                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78800  Tumor imaging limited area                        A   0.66   4.80     4.54     4.80NA   4.54 NA  0.07   5.53   5.27   5.53   5.27  1XXX.00.00.0000000             25.5217 090 99     11.55  11.55   0.11
78800TCTumor imaging limited area                        A   0.00   4.54     4.29     4.54NA   4.29 NA  0.03   4.57   4.32   4.57   4.32  1XXX.00.00.0000000             25.5217 010 99     11.29  11.29   0.07
7880026Tumor imaging limited area                        A   0.66   0.26     0.25     0.26     0.25     0.04   0.96   0.95   0.96   0.95  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78801  Tumor imaging mult areas                          A   0.79   6.60     6.29     6.60NA   6.29 NA  0.07   7.46   7.15   7.46   7.15  1XXX.00.00.0000000             25.5217 090 99     18.84  18.84   0.13
78801TCTumor imaging mult areas                          A   0.00   6.28     6.00     6.28NA   6.00 NA  0.03   6.31   6.03   6.31   6.03  1XXX.00.00.0000000             25.5217 010 99     18.52  18.52   0.09
7880126Tumor imaging mult areas                          A   0.79   0.32     0.29     0.32     0.29     0.04   1.15   1.12   1.15   1.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78802  Tumor imaging whole body                          A   0.86   8.72     8.15     8.72NA   8.15 NA  0.07   9.65   9.08   9.65   9.08  1XXX.00.00.0020000             25.5217 090 99     18.88  18.88   0.11
78802TCTumor imaging whole body                          A   0.00   8.38     7.87     8.38NA   7.87 NA  0.03   8.41   7.90   8.41   7.90  1XXX.00.00.0020000             25.5217 010 99     18.54  18.54   0.07
7880226Tumor imaging whole body                          A   0.86   0.34     0.28     0.34     0.28     0.04   1.24   1.18   1.24   1.18  1XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
78803  Tumor imaging (3D)                                A   1.09   9.21     8.38     9.21NA   8.38 NA  0.08  10.38   9.55  10.38   9.55  1XXX.00.00.0020000             25.5217 090 99     18.97  18.97   0.11
78803TCTumor imaging (3D)                                A   0.00   8.79     8.05     8.79NA   8.05 NA  0.03   8.82   8.08   8.82   8.08  1XXX.00.00.0020000             25.5217 010 99     18.55  18.55   0.06
7880326Tumor imaging (3D)                                A   1.09   0.42     0.33     0.42     0.33     0.05   1.56   1.47   1.56   1.47  1XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
78804  Tumor imaging whole body                          A   1.07  15.99    14.85    15.99NA  14.85 NA  0.10  17.16  16.02  17.16  16.02  1XXX.00.00.0000000             25.5217 090 99     32.65  32.65   0.15
78804TCTumor imaging whole body                          A   0.00  15.57    14.50    15.57NA  14.50 NA  0.05  15.62  14.55  15.62  14.55  1XXX.00.00.0000000             25.5217 010 99     32.23  32.23   0.10
7880426Tumor imaging whole body                          A   1.07   0.42     0.35     0.42     0.35     0.05   1.54   1.47   1.54   1.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78805  Abscess imaging ltd area                          A   0.73   4.65     4.30     4.65NA   4.30 NA  0.07   5.45   5.10   5.45   5.10  1XXX.00.00.0000000             25.5217 090 99     18.77  18.77   0.17
78805TCAbscess imaging ltd area                          A   0.00   4.36     4.05     4.36NA   4.05 NA  0.03   4.39   4.08   4.39   4.08  1XXX.00.00.0000000             25.5217 010 99     18.48  18.48   0.13
7880526Abscess imaging ltd area                          A   0.73   0.29     0.25     0.29     0.25     0.04   1.06   1.02   1.06   1.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78806  Abscess imaging whole body                        A   0.86   9.07     8.40     9.07NA   8.40 NA  0.07  10.00   9.33  10.00   9.33  1XXX.00.00.0020000             25.5217 090 99     18.89  18.89   0.10
78806TCAbscess imaging whole body                        A   0.00   8.73     8.11     8.73NA   8.11 NA  0.03   8.76   8.14   8.76   8.14  1XXX.00.00.0020000             25.5217 010 99     18.55  18.55   0.06
7880626Abscess imaging whole body                        A   0.86   0.34     0.29     0.34     0.29     0.04   1.24   1.19   1.24   1.19  1XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
78807  Nuclear localization/abscess                      A   1.09   9.21     8.36     9.21NA   8.36 NA  0.07  10.37   9.52  10.37   9.52  1XXX.00.00.0020000             25.5217 090 99     18.97  18.97   0.10
78807TCNuclear localization/abscess                      A   0.00   8.79     8.04     8.79NA   8.04 NA  0.03   8.82   8.07   8.82   8.07  1XXX.00.00.0020000             25.5217 010 99     18.55  18.55   0.06
7880726Nuclear localization/abscess                      A   1.09   0.42     0.32     0.42     0.32     0.04   1.55   1.45   1.55   1.45  1XXX.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
78808  Iv inj ra drug dx study                           A   0.18   1.06     0.89     1.06NA   0.89 NA  0.03   1.27   1.10   1.27   1.10  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78811  Pet image ltd area                                C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     41.45  41.45   0.19
78811TCPet image ltd area                                C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     40.82  40.82   0.01
7881126Pet image ltd area                                A   1.54   0.63     0.55     0.63     0.55     0.18   2.35   2.27   2.35   2.27  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78812  Pet image skull-thigh                             C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     41.60  41.60   0.17
78812TCPet image skull-thigh                             C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     40.82  40.82   0.01
7881226Pet image skull-thigh                             A   1.93   0.78     0.66     0.78     0.66     0.16   2.87   2.75   2.87   2.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78813  Pet image full body                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     41.65  41.65   0.19
78813TCPet image full body                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     40.82  40.82   0.01
7881326Pet image full body                               A   2.00   0.83     0.72     0.83     0.72     0.18   3.01   2.90   3.01   2.90  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78814  Pet image w/ct lmtd                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     41.69  41.69   0.21
78814TCPet image w/ct lmtd                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     40.82  40.82   0.01
7881426Pet image w/ct lmtd                               A   2.20   0.87     0.73     0.87     0.73     0.20   3.27   3.13   3.27   3.13  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78815  Pet image w/ct skull-thigh                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     41.80  41.80   0.23
78815TCPet image w/ct skull-thigh                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     40.82  40.82   0.01
7881526Pet image w/ct skull-thigh                        A   2.44   0.98     0.84     0.98     0.84     0.22   3.64   3.50   3.64   3.50  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78816  Pet image w/ct full body                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     41.80  41.80   0.23
78816TCPet image w/ct full body                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99     40.82  40.82   0.01
7881626Pet image w/ct full body                          A   2.50   0.98     0.80     0.98     0.80     0.22   3.70   3.52   3.70   3.52  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78999  Nuclear diagnostic exam                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
78999TCNuclear diagnostic exam                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7899926Nuclear diagnostic exam                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79005  Nuclear rx oral admin                             A   1.80   2.33     1.93     2.33NA   1.93 NA  0.08   4.21   3.81   4.21   3.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79005TCNuclear rx oral admin                             A   0.00   1.61     1.27     1.61NA   1.27 NA  0.01   1.62   1.28   1.62   1.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7900526Nuclear rx oral admin                             A   1.80   0.72     0.66     0.72     0.66     0.07   2.59   2.53   2.59   2.53  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79101  Nuclear rx iv admin                               A   1.96   2.72     2.25     2.72NA   2.25 NA  0.08   4.76   4.29   4.76   4.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79101TCNuclear rx iv admin                               A   0.00   1.74     1.35     1.74NA   1.35 NA  0.01   1.75   1.36   1.75   1.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7910126Nuclear rx iv admin                               A   1.96   0.98     0.90     0.98     0.90     0.07   3.01   2.93   3.01   2.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79200  Nuclear rx intracav admin                         A   1.99   2.83     2.43     2.83NA   2.43 NA  0.12   4.94   4.54   4.94   4.54  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79200TCNuclear rx intracav admin                         A   0.00   1.99     1.67     1.99NA   1.67 NA  0.01   2.00   1.68   2.00   1.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7920026Nuclear rx intracav admin                         A   1.99   0.84     0.76     0.84     0.76     0.11   2.94   2.86   2.94   2.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79300  Nuclr rx interstit colloid                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79300TCNuclr rx interstit colloid                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7930026Nuclr rx interstit colloid                        A   1.60   0.66     0.61     0.66     0.61     0.14   2.40   2.35   2.40   2.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79403  Hematopoietic nuclear tx                          A   2.25   3.64     2.89     3.64NA   2.89 NA  0.14   6.03   5.28   6.03   5.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79403TCHematopoietic nuclear tx                          A   0.00   2.70     2.08     2.70NA   2.08 NA  0.03   2.73   2.11   2.73   2.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7940326Hematopoietic nuclear tx                          A   2.25   0.94     0.81     0.94     0.81     0.11   3.30   3.17   3.30   3.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79440  Nuclear rx intra-articular                        A   1.99   2.59     2.38     2.59NA   2.38 NA  0.06   4.64   4.43   4.64   4.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79440TCNuclear rx intra-articular                        A   0.00   1.67     1.46     1.67NA   1.46 NA  0.01   1.68   1.47   1.68   1.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7944026Nuclear rx intra-articular                        A   1.99   0.92     0.92     0.92     0.92     0.05   2.96   2.96   2.96   2.96  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79445  Nuclear rx intra-arterial                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79445TCNuclear rx intra-arterial                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7944526Nuclear rx intra-arterial                         A   2.40   0.94     0.77     0.94     0.77     0.20   3.54   3.37   3.54   3.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79999  Nuclear medicine therapy                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
79999TCNuclear medicine therapy                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
7999926Nuclear medicine therapy                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
80047  Metabolic panel ionized ca                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80048  Metabolic panel total ca                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80050  General health panel                              N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80051  Electrolyte panel                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80053  Comprehen metabolic panel                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80055  Obstetric panel                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80061  Lipid panel                                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80069  Renal function panel                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80074  Acute hepatitis panel                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80076  Hepatic function panel                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80100  Drug screen qualitate/multi                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80101  Drug screen single                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80102  Drug confirmation                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80103  Drug analysis tissue prep                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80104  Drug scrn 1+ class nonchromo                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80150  Assay of amikacin                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80152  Assay of amitriptyline                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80154  Assay of benzodiazepines                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80156  Assay carbamazepine total                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80157  Assay carbamazepine free                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80158  Assay of cyclosporine                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80160  Assay of desipramine                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80162  Assay of digoxin                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80164  Assay dipropylacetic acid                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80166  Assay of doxepin                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80168  Assay of ethosuximide                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80170  Assay of gentamicin                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80172  Assay of gold                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80173  Assay of haloperidol                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80174  Assay of imipramine                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80176  Assay of lidocaine                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80178  Assay of lithium                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80182  Assay of nortriptyline                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80184  Assay of phenobarbital                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80185  Assay of phenytoin total                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80186  Assay of phenytoin free                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80188  Assay of primidone                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80190  Assay of procainamide                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80192  Assay of procainamide                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80194  Assay of quinidine                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80195  Assay of sirolimus                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80196  Assay of salicylate                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80197  Assay of tacrolimus                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80198  Assay of theophylline                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80200  Assay of tobramycin                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80201  Assay of topiramate                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80202  Assay of vancomycin                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80299  Quantitative assay drug                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80400  Acth stimulation panel                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80402  Acth stimulation panel                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80406  Acth stimulation panel                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80408  Aldosterone suppression eval                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80410  Calcitonin stimul panel                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80412  CRH stimulation panel                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80414  Testosterone response                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80415  Estradiol response panel                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80416  Renin stimulation panel                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80417  Renin stimulation panel                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80418  Pituitary evaluation panel                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80420  Dexamethasone panel                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80422  Glucagon tolerance panel                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80424  Glucagon tolerance panel                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80426  Gonadotropin hormone panel                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80428  Growth hormone panel                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80430  Growth hormone panel                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80432  Insulin suppression panel                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80434  Insulin tolerance panel                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80435  Insulin tolerance panel                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80436  Metyrapone panel                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80438  TRH stimulation panel                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80439  TRH stimulation panel                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80440  TRH stimulation panel                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
80500  Lab pathology consultation                        A   0.37   0.21     0.19     0.14     0.12     0.03   0.61   0.59   0.54   0.52  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
80502  Lab pathology consultation                        A   1.33   0.49     0.47     0.43     0.41     0.07   1.89   1.87   1.83   1.81  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
81000  Urinalysis nonauto w/scope                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81001  Urinalysis auto w/scope                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81002  Urinalysis nonauto w/o scope                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81003  Urinalysis auto w/o scope                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81005  Urinalysis                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81007  Urine screen for bacteria                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81015  Microscopic exam of urine                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81020  Urinalysis glass test                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81025  Urine pregnancy test                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81050  Urinalysis volume measure                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
81099  Urinalysis test procedure                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82000  Assay of blood acetaldehyde                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82003  Assay of acetaminophen                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82009  Test for acetone/ketones                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82010  Acetone assay                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82013  Acetylcholinesterase assay                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82016  Acylcarnitines qual                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82017  Acylcarnitines quant                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82024  Assay of acth                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82030  Assay of adp & amp                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82040  Assay of serum albumin                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82042  Assay of urine albumin                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82043  Microalbumin quantitative                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82044  Microalbumin semiquant                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82045  Albumin ischemia modified                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82055  Assay of ethanol                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82075  Assay of breath ethanol                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82085  Assay of aldolase                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82088  Assay of aldosterone                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82101  Assay of urine alkaloids                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82103  Alpha-1-antitrypsin total                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82104  Alpha-1-antitrypsin pheno                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82105  Alpha-fetoprotein serum                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82106  Alpha-fetoprotein amniotic                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82107  Alpha-fetoprotein l3                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82108  Assay of aluminum                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82120  Amines vaginal fluid qual                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82127  Amino acid single qual                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82128  Amino acids mult qual                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82131  Amino acids single quant                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82135  Assay aminolevulinic acid                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82136  Amino acids quant 2-5                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82139  Amino acids quan 6 or more                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82140  Assay of ammonia                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82143  Amniotic fluid scan                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82145  Assay of amphetamines                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82150  Assay of amylase                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82154  Androstanediol glucuronide                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82157  Assay of androstenedione                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82160  Assay of androsterone                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82163  Assay of angiotensin II                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82164  Angiotensin I enzyme test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82172  Assay of apolipoprotein                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82175  Assay of arsenic                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82180  Assay of ascorbic acid                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82190  Atomic absorption                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82205  Assay of barbiturates                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82232  Assay of beta-2 protein                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82239  Bile acids total                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82240  Bile acids cholylglycine                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82247  Bilirubin total                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82248  Bilirubin direct                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82252  Fecal bilirubin test                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82261  Assay of biotinidase                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82270  Occult blood feces                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82271  Occult blood other sources                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82272  Occult bld feces 1-3 tests                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82274  Assay test for blood fecal                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82286  Assay of bradykinin                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82300  Assay of cadmium                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82306  Vitamin d 25 hydroxy                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82308  Assay of calcitonin                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82310  Assay of calcium                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82330  Assay of calcium                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82331  Calcium infusion test                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82340  Assay of calcium in urine                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82355  Calculus analysis qual                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82360  Calculus assay quant                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82365  Calculus spectroscopy                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82370  X-ray assay calculus                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82373  Assay c-d transfer measure                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82374  Assay blood carbon dioxide                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82375  Assay carboxyhb quant                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82376  Assay carboxyhb qual                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82378  Carcinoembryonic antigen                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82379  Assay of carnitine                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82380  Assay of carotene                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82382  Assay urine catecholamines                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82383  Assay blood catecholamines                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82384  Assay three catecholamines                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82387  Assay of cathepsin-d                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82390  Assay of ceruloplasmin                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82397  Chemiluminescent assay                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82415  Assay of chloramphenicol                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82435  Assay of blood chloride                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82436  Assay of urine chloride                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82438  Assay other fluid chlorides                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82441  Test for chlorohydrocarbons                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82465  Assay bld/serum cholesterol                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82480  Assay serum cholinesterase                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82482  Assay rbc cholinesterase                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82485  Assay chondroitin sulfate                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82486  Gas/liquid chromatography                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82487  Paper chromatography                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82488  Paper chromatography                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82489  Thin layer chromatography                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82491  Chromotography quant sing                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82492  Chromotography quant mult                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82495  Assay of chromium                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82507  Assay of citrate                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82520  Assay of cocaine                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82523  Collagen crosslinks                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82525  Assay of copper                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82528  Assay of corticosterone                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82530  Cortisol free                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82533  Total cortisol                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82540  Assay of creatine                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82541  Column chromotography qual                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82542  Column chromotography quant                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82543  Column chromotograph/isotope                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82544  Column chromotograph/isotope                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82550  Assay of ck (cpk)                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82552  Assay of cpk in blood                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82553  Creatine mb fraction                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82554  Creatine isoforms                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82565  Assay of creatinine                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82570  Assay of urine creatinine                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82575  Creatinine clearance test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82585  Assay of cryofibrinogen                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82595  Assay of cryoglobulin                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82600  Assay of cyanide                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82607  Vitamin B-12                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82608  B-12 binding capacity                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82610  Cystatin c                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82615  Test for urine cystines                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82626  Dehydroepiandrosterone                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82627  Dehydroepiandrosterone                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82633  Desoxycorticosterone                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82634  Deoxycortisol                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82638  Assay of dibucaine number                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82646  Assay of dihydrocodeinone                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82649  Assay of dihydromorphinone                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82651  Assay of dihydrotestosterone                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82652  Vit d 1 25-dihydroxy                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82654  Assay of dimethadione                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82656  Pancreatic elastase fecal                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82657  Enzyme cell activity                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82658  Enzyme cell activity ra                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82664  Electrophoretic test                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82666  Assay of epiandrosterone                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82668  Assay of erythropoietin                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82670  Assay of estradiol                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82671  Assay of estrogens                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82672  Assay of estrogen                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82677  Assay of estriol                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82679  Assay of estrone                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82690  Assay of ethchlorvynol                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82693  Assay of ethylene glycol                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82696  Assay of etiocholanolone                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82705  Fats/lipids feces qual                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82710  Fats/lipids feces quant                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82715  Assay of fecal fat                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82725  Assay of blood fatty acids                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82726  Long chain fatty acids                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82728  Assay of ferritin                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82731  Assay of fetal fibronectin                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82735  Assay of fluoride                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82742  Assay of flurazepam                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82746  Blood folic acid serum                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82747  Assay of folic acid rbc                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82757  Assay of semen fructose                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82759  Assay of rbc galactokinase                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82760  Assay of galactose                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82775  Assay galactose transferase                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82776  Galactose transferase test                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82784  Assay iga/igd/igg/igm each                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82785  Assay of ige                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82787  Igg 1 2 3 or 4 each                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82800  Blood pH                                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82803  Blood gases any combination                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82805  Blood gases w/o2 saturation                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82810  Blood gases o2 sat only                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82820  Hemoglobin-oxygen affinity                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82930  Gastric analy w/ph ea spec                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82938  Gastrin test                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82941  Assay of gastrin                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82943  Assay of glucagon                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82945  Glucose other fluid                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82946  Glucagon tolerance test                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82947  Assay glucose blood quant                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82948  Reagent strip/blood glucose                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82950  Glucose test                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82951  Glucose tolerance test (GTT)                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82952  GTT-added samples                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82953  Glucose-tolbutamide test                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82955  Assay of g6pd enzyme                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82960  Test for G6PD enzyme                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82962  Glucose blood test                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82963  Assay of glucosidase                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82965  Assay of gdh enzyme                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82975  Assay of glutamine                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82977  Assay of GGT                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82978  Assay of glutathione                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82979  Assay rbc glutathione                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82980  Assay of glutethimide                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
82985  Glycated protein                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83001  Gonadotropin (FSH)                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83002  Gonadotropin (LH)                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83003  Assay growth hormone (hgh)                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83008  Assay of guanosine                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83009  H pylori (c-13) blood                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83010  Assay of haptoglobin quant                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83012  Assay of haptoglobins                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83013  H pylori (c-13) breath                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83014  H pylori drug admin                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83015  Heavy metal screen                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83018  Quantitative screen metals                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83020  Hemoglobin electrophoresis                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8302026Hemoglobin electrophoresis                        A   0.37   0.17     0.18     0.17     0.18     0.03   0.57   0.58   0.57   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
83021  Hemoglobin chromotography                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83026  Hemoglobin copper sulfate                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83030  Fetal hemoglobin chemical                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83033  Fetal hemoglobin assay qual                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83036  Glycosylated hemoglobin test                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83037  Glycosylated hb home device                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83045  Blood methemoglobin test                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83050  Blood methemoglobin assay                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83051  Assay of plasma hemoglobin                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83055  Blood sulfhemoglobin test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83060  Blood sulfhemoglobin assay                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83065  Assay of hemoglobin heat                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83068  Hemoglobin stability screen                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83069  Assay of urine hemoglobin                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83070  Assay of hemosiderin qual                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83071  Assay of hemosiderin quant                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83080  Assay of b hexosaminidase                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83088  Assay of histamine                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83090  Assay of homocystine                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83150  Assay of for hva                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83491  Assay of corticosteroids                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83497  Assay of 5-hiaa                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83498  Assay of progesterone                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83499  Assay of progesterone                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83500  Assay free hydroxyproline                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83505  Assay total hydroxyproline                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83516  Immunoassay nonantibody                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83518  Immunoassay dipstick                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83519  Ria nonantibody                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83520  Immunoassay quant nos nonab                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83525  Assay of insulin                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83527  Assay of insulin                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83528  Assay of intrinsic factor                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83540  Assay of iron                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83550  Iron binding test                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83570  Assay of idh enzyme                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83582  Assay of ketogenic steroids                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83586  Assay 17- ketosteroids                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83593  Fractionation ketosteroids                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83605  Assay of lactic acid                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83615  Lactate (LD) (LDH) enzyme                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83625  Assay of ldh enzymes                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83630  Lactoferrin fecal (qual)                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83631  Lactoferrin fecal (quant)                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83632  Placental lactogen                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83633  Test urine for lactose                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83634  Assay of urine for lactose                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83655  Assay of lead                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83661  L/s ratio fetal lung                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83662  Foam stability fetal lung                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83663  Fluoro polarize fetal lung                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83664  Lamellar bdy fetal lung                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83670  Assay of lap enzyme                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83690  Assay of lipase                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83695  Assay of lipoprotein(a)                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83698  Assay lipoprotein pla2                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83700  Lipopro bld electrophoretic                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83701  Lipoprotein bld hr fraction                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83704  Lipoprotein bld by nmr                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83718  Assay of lipoprotein                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83719  Assay of blood lipoprotein                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83721  Assay of blood lipoprotein                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83727  Assay of lrh hormone                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83735  Assay of magnesium                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83775  Assay of md enzyme                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83785  Assay of manganese                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83788  Mass spectrometry qual                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83789  Mass spectrometry quant                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83805  Assay of meprobamate                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83825  Assay of mercury                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83835  Assay of metanephrines                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83840  Assay of methadone                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83857  Assay of methemalbumin                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83858  Assay of methsuximide                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83861  Microfluid analy tears                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83864  Mucopolysaccharides                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83866  Mucopolysaccharides screen                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83872  Assay synovial fluid mucin                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83873  Assay of csf protein                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83874  Assay of myoglobin                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83876  Assay myeloperoxidase                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83880  Natriuretic peptide                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83883  Assay nephelometry not spec                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83885  Assay of nickel                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83887  Assay of nicotine                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83890  Molecule isolate                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83891  Molecule isolate nucleic                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83892  Molecular diagnostics                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83893  Molecule dot/slot/blot                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83894  Molecule gel electrophor                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83896  Molecular diagnostics                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83897  Molecule nucleic transfer                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83898  Molecule nucleic ampli each                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83900  Molecule nucleic ampli 2 seq                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83901  Molecule nucleic ampli addon                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83902  Molecular diagnostics                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83903  Molecule mutation scan                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83904  Molecule mutation identify                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83905  Molecule mutation identify                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83906  Molecule mutation identify                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83907  Lyse cells for nucleic ext                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83908  Nucleic acid signal ampli                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83909  Nucleic acid high resolute                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83912  Genetic examination                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8391226Genetic examination                               A   0.37   0.15     0.16     0.15     0.16     0.03   0.55   0.56   0.55   0.56  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
83913  Molecular rna stabilization                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83914  Mutation ident ola/sbce/aspe                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83915  Assay of nucleotidase                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83916  Oligoclonal bands                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83918  Organic acids total quant                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83919  Organic acids qual each                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83921  Organic acid single quant                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83925  Assay of opiates                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83930  Assay of blood osmolality                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83935  Assay of urine osmolality                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83937  Assay of osteocalcin                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83945  Assay of oxalate                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83950  Oncoprotein her-2/neu                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83951  Oncoprotein dcp                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83970  Assay of parathormone                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83986  Assay ph body fluid nos                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83987  Exhaled breath condensate                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83992  Assay for phencyclidine                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
83993  Assay for calprotectin fecal                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84022  Assay of phenothiazine                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84030  Assay of blood pku                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84035  Assay of phenylketones                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84060  Assay acid phosphatase                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84061  Phosphatase forensic exam                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84066  Assay prostate phosphatase                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84075  Assay alkaline phosphatase                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84078  Assay alkaline phosphatase                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84080  Assay alkaline phosphatases                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84081  Amniotic fluid enzyme test                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84085  Assay of rbc pg6d enzyme                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84087  Assay phosphohexose enzymes                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84100  Assay of phosphorus                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84105  Assay of urine phosphorus                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84106  Test for porphobilinogen                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84110  Assay of porphobilinogen                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84112  Placenta alpha micro ig c/v                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84119  Test urine for porphyrins                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84120  Assay of urine porphyrins                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84126  Assay of feces porphyrins                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84127  Assay of feces porphyrins                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84132  Assay of serum potassium                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84133  Assay of urine potassium                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84134  Assay of prealbumin                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84135  Assay of pregnanediol                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84138  Assay of pregnanetriol                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84140  Assay of pregnenolone                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84143  Assay of 17-hydroxypregneno                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84144  Assay of progesterone                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84145  Procalcitonin (pct)                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84146  Assay of prolactin                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84150  Assay of prostaglandin                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84152  Assay of psa complexed                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84153  Assay of psa total                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84154  Assay of psa free                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84155  Assay of protein serum                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84156  Assay of protein urine                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84157  Assay of protein other                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84160  Assay of protein any source                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84163  Pappa serum                                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84165  Protein e-phoresis serum                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8416526Protein e-phoresis serum                          A   0.37   0.16     0.18     0.16     0.18     0.03   0.56   0.58   0.56   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
84166  Protein e-phoresis/urine/csf                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8416626Protein e-phoresis/urine/csf                      A   0.37   0.16     0.18     0.16     0.18     0.03   0.56   0.58   0.56   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
84181  Western blot test                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8418126Western blot test                                 A   0.37   0.17     0.18     0.17     0.18     0.03   0.57   0.58   0.57   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
84182  Protein western blot test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8418226Protein western blot test                         A   0.37   0.16     0.17     0.16     0.17     0.03   0.56   0.57   0.56   0.57  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
84202  Assay RBC protoporphyrin                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84203  Test RBC protoporphyrin                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84206  Assay of proinsulin                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84207  Assay of vitamin b-6                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84210  Assay of pyruvate                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84220  Assay of pyruvate kinase                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84228  Assay of quinine                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84233  Assay of estrogen                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84234  Assay of progesterone                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84235  Assay of endocrine hormone                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84238  Assay nonendocrine receptor                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84244  Assay of renin                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84252  Assay of vitamin b-2                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84255  Assay of selenium                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84260  Assay of serotonin                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84270  Assay of sex hormone globul                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84275  Assay of sialic acid                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84285  Assay of silica                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84295  Assay of serum sodium                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84300  Assay of urine sodium                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84302  Assay of sweat sodium                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84305  Assay of somatomedin                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84307  Assay of somatostatin                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84311  Spectrophotometry                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84315  Body fluid specific gravity                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84375  Chromatogram assay sugars                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84376  Sugars single qual                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84377  Sugars multiple qual                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84378  Sugars single quant                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84379  Sugars multiple quant                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84392  Assay of urine sulfate                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84402  Assay of testosterone                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84403  Assay of total testosterone                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84425  Assay of vitamin b-1                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84430  Assay of thiocyanate                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84431  Thromboxane urine                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84432  Assay of thyroglobulin                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84436  Assay of total thyroxine                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84437  Assay of neonatal thyroxine                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84439  Assay of free thyroxine                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84442  Assay of thyroid activity                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84443  Assay thyroid stim hormone                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84445  Assay of tsi                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84446  Assay of vitamin e                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84449  Assay of transcortin                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84450  Transferase (AST) (SGOT)                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84460  Alanine amino (ALT) (SGPT)                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84466  Assay of transferrin                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84478  Assay of triglycerides                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84479  Assay of thyroid (t3 or t4)                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84480  Assay triiodothyronine (t3)                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84481  Free assay (FT-3)                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84482  T3 reverse                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84484  Assay of troponin quant                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84485  Assay duodenal fluid trypsin                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84488  Test feces for trypsin                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84490  Assay of feces for trypsin                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84510  Assay of tyrosine                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84512  Assay of troponin qual                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84520  Assay of urea nitrogen                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84525  Urea nitrogen semi-quant                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84540  Assay of urine/urea-n                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84545  Urea-N clearance test                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84550  Assay of blood/uric acid                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84560  Assay of urine/uric acid                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84577  Assay of feces/urobilinogen                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84578  Test urine urobilinogen                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84580  Assay of urine urobilinogen                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84583  Assay of urine urobilinogen                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84585  Assay of urine vma                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84586  Assay of vip                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84588  Assay of vasopressin                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84590  Assay of vitamin a                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84591  Assay of nos vitamin                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84597  Assay of vitamin k                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84600  Assay of volatiles                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84620  Xylose tolerance test                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84630  Assay of zinc                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84681  Assay of c-peptide                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84702  Chorionic gonadotropin test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84703  Chorionic gonadotropin assay                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84704  Hcg free betachain test                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84830  Ovulation tests                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
84999  Clinical chemistry test                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85002  Bleeding time test                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85004  Automated diff wbc count                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85007  Bl smear w/diff wbc count                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85008  Bl smear w/o diff wbc count                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85009  Manual diff wbc count b-coat                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85013  Spun microhematocrit                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85014  Hematocrit                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85018  Hemoglobin                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85025  Complete cbc w/auto diff wbc                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85027  Complete cbc automated                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85032  Manual cell count each                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85041  Automated rbc count                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85044  Manual reticulocyte count                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85045  Automated reticulocyte count                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85046  Reticyte/hgb concentrate                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85048  Automated leukocyte count                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85049  Automated platelet count                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85055  Reticulated platelet assay                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85060  Blood smear interpretation                        A   0.45   0.20     0.22     0.20     0.22     0.03   0.68   0.70   0.68   0.70  8XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
85097  Bone marrow interpretation                        A   0.94   1.54     1.37     0.39     0.40     0.05   2.53   2.36   1.38   1.39  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
85130  Chromogenic substrate assay                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85170  Blood clot retraction                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85175  Blood clot lysis time                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85210  Blood clot factor II test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85220  Blood clot factor V test                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85230  Blood clot factor VII test                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85240  Blood clot factor VIII test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85244  Blood clot factor VIII test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85245  Blood clot factor VIII test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85246  Blood clot factor VIII test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85247  Blood clot factor VIII test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85250  Blood clot factor IX test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85260  Blood clot factor X test                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85270  Blood clot factor XI test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85280  Blood clot factor XII test                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85290  Blood clot factor XIII test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85291  Blood clot factor XIII test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85292  Blood clot factor assay                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85293  Blood clot factor assay                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85300  Antithrombin III test                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85301  Antithrombin III test                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85302  Blood clot inhibitor antigen                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85303  Blood clot inhibitor test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85305  Blood clot inhibitor assay                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85306  Blood clot inhibitor test                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85307  Assay activated protein c                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85335  Factor inhibitor test                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85337  Thrombomodulin                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85345  Coagulation time                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85347  Coagulation time                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85348  Coagulation time                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85360  Euglobulin lysis                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85362  Fibrin degradation products                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85366  Fibrinogen test                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85370  Fibrinogen test                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85378  Fibrin degrade semiquant                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85379  Fibrin degradation quant                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85380  Fibrin degradation vte                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85384  Fibrinogen                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85385  Fibrinogen                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85390  Fibrinolysins screen                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8539026Fibrinolysins screen                              A   0.37   0.18     0.19     0.18     0.19     0.03   0.58   0.59   0.58   0.59  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
85396  Clotting assay whole blood                        A   0.37   0.16NA   0.17NA   0.16     0.17     0.03   0.56   0.57   0.56   0.57  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
85397  Clotting funct activity                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85400  Fibrinolytic plasmin                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85410  Fibrinolytic antiplasmin                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85415  Fibrinolytic plasminogen                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85420  Fibrinolytic plasminogen                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85421  Fibrinolytic plasminogen                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85441  Heinz bodies direct                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85445  Heinz bodies induced                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85460  Hemoglobin fetal                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85461  Hemoglobin fetal                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85475  Hemolysin                                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85520  Heparin assay                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85525  Heparin neutralization                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85530  Heparin-protamine tolerance                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85536  Iron stain peripheral blood                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85540  Wbc alkaline phosphatase                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85547  RBC mechanical fragility                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85549  Muramidase                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85555  RBC osmotic fragility                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85557  RBC osmotic fragility                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85576  Blood platelet aggregation                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8557626Blood platelet aggregation                        A   0.37   0.17     0.18     0.17     0.18     0.03   0.57   0.58   0.57   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
85597  Phospholipid pltlt neutraliz                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85598  Hexagnal phosph pltlt neutrl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85610  Prothrombin time                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85611  Prothrombin test                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85612  Viper venom prothrombin time                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85613  Russell viper venom diluted                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85635  Reptilase test                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85651  Rbc sed rate nonautomated                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85652  Rbc sed rate automated                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85660  RBC sickle cell test                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85670  Thrombin time plasma                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85675  Thrombin time titer                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85705  Thromboplastin inhibition                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85730  Thromboplastin time partial                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85732  Thromboplastin time partial                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85810  Blood viscosity examination                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
85999  Hematology procedure                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86000  Agglutinins febrile                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86001  Allergen specific igg                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86003  Allergen specific IgE                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86005  Allergen specific IgE                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86021  WBC antibody identification                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86022  Platelet antibodies                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86023  Immunoglobulin assay                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86038  Antinuclear antibodies                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86039  Antinuclear antibodies (ANA)                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86060  Antistreptolysin o titer                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86063  Antistreptolysin o screen                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86077  Physician blood bank service                      A   0.94   0.51     0.55     0.43     0.46     0.05   1.50   1.54   1.42   1.45  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86078  Physician blood bank service                      A   0.94   0.52     0.56     0.43     0.46     0.05   1.51   1.55   1.42   1.45  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86079  Physician blood bank service                      A   0.94   0.53     0.55     0.43     0.45     0.05   1.52   1.54   1.42   1.44  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86140  C-reactive protein                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86141  C-reactive protein hs                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86146  Glycoprotein antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86147  Cardiolipin antibody                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86148  Phospholipid antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86155  Chemotaxis assay                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86156  Cold agglutinin screen                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86157  Cold agglutinin titer                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86160  Complement antigen                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86161  Complement/function activity                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86162  Complement total (ch50)                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86171  Complement fixation each                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86185  Counterimmunoelectrophoresis                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86200  Ccp antibody                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86215  Deoxyribonuclease antibody                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86225  DNA antibody                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86226  Dna antibody single strand                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86235  Nuclear antigen antibody                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86243  Fc receptor                                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86255  Fluorescent antibody screen                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8625526Fluorescent antibody screen                       A   0.37   0.17     0.18     0.17     0.18     0.03   0.57   0.58   0.57   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86256  Fluorescent antibody titer                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8625626Fluorescent antibody titer                        A   0.37   0.17     0.18     0.17     0.18     0.01   0.55   0.56   0.55   0.56  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86277  Growth hormone antibody                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86280  Hemagglutination inhibition                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86294  Immunoassay tumor qual                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86300  Immunoassay tumor ca 15-3                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86301  Immunoassay tumor ca 19-9                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86304  Immunoassay tumor ca 125                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86305  Human epididymis protein 4                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86308  Heterophile antibodies                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86309  Heterophile antibodies                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86310  Heterophile antibodies                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86316  Immunoassay tumor other                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86317  Immunoassay infectious agent                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86318  Immunoassay infectious agent                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86320  Serum immunoelectrophoresis                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8632026Serum immunoelectrophoresis                       A   0.37   0.17     0.18     0.17     0.18     0.01   0.55   0.56   0.55   0.56  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86325  Other immunoelectrophoresis                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8632526Other immunoelectrophoresis                       A   0.37   0.16     0.18     0.16     0.18     0.01   0.54   0.56   0.54   0.56  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86327  Immunoelectrophoresis assay                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8632726Immunoelectrophoresis assay                       A   0.42   0.20     0.21     0.20     0.21     0.03   0.65   0.66   0.65   0.66  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86329  Immunodiffusion                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86331  Immunodiffusion ouchterlony                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86332  Immune complex assay                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86334  Immunofix e-phoresis serum                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8633426Immunofix e-phoresis serum                        A   0.37   0.17     0.18     0.17     0.18     0.03   0.57   0.58   0.57   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86335  Immunfix e-phorsis/urine/csf                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8633526Immunfix e-phorsis/urine/csf                      A   0.37   0.17     0.18     0.17     0.18     0.03   0.57   0.58   0.57   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86336  Inhibin A                                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86337  Insulin antibodies                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86340  Intrinsic factor antibody                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86341  Islet cell antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86343  Leukocyte histamine release                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86344  Leukocyte phagocytosis                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86352  Cell function assay w/stim                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86353  Lymphocyte transformation                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86355  B cells total count                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86356  Mononuclear cell antigen                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86357  Nk cells total count                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86359  T cells total count                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86360  T cell absolute count/ratio                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86361  T cell absolute count                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86367  Stem cells total count                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86376  Microsomal antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86378  Migration inhibitory factor                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86382  Neutralization test viral                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86384  Nitroblue tetrazolium dye                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86403  Particle agglutination test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86406  Particle agglutination test                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86430  Rheumatoid factor test                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86431  Rheumatoid factor quant                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86480  Tb test cell immun measure                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86481  Tb ag response t-cell susp                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86485  Skin test candida                                 C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86486  Skin test nos antigen                             A   0.00   0.14     0.13     0.14NA   0.13 NA  0.01   0.15   0.14   0.15   0.14  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86490  Coccidioidomycosis skin test                      A   0.00   0.19     0.17     0.19NA   0.17 NA  0.01   0.20   0.18   0.20   0.18  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86510  Histoplasmosis skin test                          A   0.00   0.19     0.16     0.19NA   0.16 NA  0.01   0.20   0.17   0.20   0.17  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86580  TB intradermal test                               A   0.00   0.21     0.20     0.21NA   0.20 NA  0.01   0.22   0.21   0.22   0.21  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
86590  Streptokinase antibody                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86592  Syphilis test non-trep qual                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86593  Syphilis test non-trep quant                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86602  Antinomyces antibody                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86603  Adenovirus antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86606  Aspergillus antibody                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86609  Bacterium antibody                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86611  Bartonella antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86612  Blastomyces antibody                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86615  Bordetella antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86617  Lyme disease antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86618  Lyme disease antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86619  Borrelia antibody                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86622  Brucella antibody                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86625  Campylobacter antibody                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86628  Candida antibody                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86631  Chlamydia antibody                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86632  Chlamydia igm antibody                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86635  Coccidioides antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86638  Q fever antibody                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86641  Cryptococcus antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86644  CMV antibody                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86645  Cmv antibody igm                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86648  Diphtheria antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86651  Encephalitis antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86652  Encephalitis antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86653  Encephalitis antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86654  Encephalitis antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86658  Enterovirus antibody                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86663  Epstein-barr antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86664  Epstein-barr antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86665  Epstein-barr antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86666  Ehrlichia antibody                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86668  Francisella tularensis                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86671  Fungus antibody                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86674  Giardia lamblia antibody                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86677  Helicobacter pylori                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86682  Helminth antibody                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86684  Hemophilus influenza                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86687  Htlv-i antibody                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86688  Htlv-ii antibody                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86689  HTLV/HIV confirmatory test                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86692  Hepatitis delta agent                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86694  Herpes simplex test                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86695  Herpes simplex test                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86696  Herpes simplex type 2                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86698  Histoplasma                                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86701  HIV-1                                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86702  HIV-2                                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86703  Hiv-1/hiv-2 single assay                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86704  Hep b core antibody total                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86705  Hep b core antibody igm                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86706  Hep b surface antibody                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86707  Hep be antibody                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86708  Hep a antibody total                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86709  Hep a antibody igm                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86710  Influenza virus antibody                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86713  Legionella antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86717  Leishmania antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86720  Leptospira antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86723  Listeria monocytogenes ab                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86727  Lymph choriomeningitis ab                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86729  Lympho venereum antibody                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86732  Mucormycosis antibody                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86735  Mumps antibody                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86738  Mycoplasma antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86741  Neisseria meningitidis                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86744  Nocardia antibody                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86747  Parvovirus antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86750  Malaria antibody                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86753  Protozoa antibody nos                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86756  Respiratory virus antibody                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86757  Rickettsia antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86759  Rotavirus antibody                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86762  Rubella antibody                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86765  Rubeola antibody                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86768  Salmonella antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86771  Shigella antibody                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86774  Tetanus antibody                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86777  Toxoplasma antibody                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86778  Toxoplasma antibody igm                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86780  Treponema pallidum                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86784  Trichinella antibody                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86787  Varicella-zoster antibody                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86788  West nile virus ab igm                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86789  West nile virus antibody                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86790  Virus antibody nos                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86793  Yersinia antibody                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86800  Thyroglobulin antibody                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86803  Hepatitis c ab test                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86804  Hep c ab test confirm                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86805  Lymphocytotoxicity assay                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86806  Lymphocytotoxicity assay                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86807  Cytotoxic antibody screening                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86808  Cytotoxic antibody screening                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86812  Hla typing a b or c                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86813  Hla typing a b or c                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86816  Hla typing dr/dq                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86817  Hla typing dr/dq                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86821  Lymphocyte culture mixed                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86822  Lymphocyte culture primed                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86825  Hla x-math non-cytotoxic                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86826  Hla x-match noncytotoxc addl                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86849  Immunology procedure                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86850  RBC antibody screen                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86860  RBC antibody elution                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86870  RBC antibody identification                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86880  Coombs test direct                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86885  Coombs test indirect qual                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86886  Coombs test indirect titer                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86890  Autologous blood process                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86891  Autologous blood op salvage                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86900  Blood typing abo                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86901  Blood typing rh (d)                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86902  Blood type antigen donor ea                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86904  Blood typing patient serum                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86905  Blood typing rbc antigens                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86906  Blood typing rh phenotype                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86910  Blood typing paternity test                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86911  Blood typing antigen system                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86920  Compatibility test spin                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86921  Compatibility test incubate                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86922  Compatibility test antiglob                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86923  Compatibility test electric                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86927  Plasma fresh frozen                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86930  Frozen blood prep                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86931  Frozen blood thaw                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86932  Frozen blood freeze/thaw                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86940  Hemolysins/agglutinins auto                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86941  Hemolysins/agglutinins                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86945  Blood product/irradiation                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86950  Leukacyte transfusion                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86960  Vol reduction of blood/prod                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86965  Pooling blood platelets                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86970  RBC pretreatment                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86971  RBC pretreatment                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86972  RBC pretreatment                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86975  Rbc pretreatment serum                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86976  Rbc pretreatment serum                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86977  Rbc pretreatment serum                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86978  Rbc pretreatment serum                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86985  Split blood or products                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
86999  Transfusion procedure                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87001  Small animal inoculation                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87003  Small animal inoculation                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87015  Specimen concentration                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87040  Blood culture for bacteria                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87045  Feces culture bacteria                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87046  Stool cultr bacteria each                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87070  Culture bacteria other                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87071  Culture bacteri aerobic othr                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87073  Culture bacteria anaerobic                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87075  Cultr bacteria except blood                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87076  Culture anaerobe ident each                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87077  Culture aerobic identify                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87081  Culture screen only                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87084  Culture of specimen by kit                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87086  Urine culture/colony count                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87088  Urine bacteria culture                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87101  Skin fungi culture                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87102  Fungus isolation culture                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87103  Blood fungus culture                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87106  Fungi identification yeast                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87107  Fungi identification mold                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87109  Mycoplasma                                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87110  Chlamydia culture                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87116  Mycobacteria culture                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87118  Mycobacteric identification                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87140  Culture type immunofluoresc                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87143  Culture typing glc/hplc                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87147  Culture type immunologic                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87149  Dna/rna direct probe                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87150  Dna/rna amplified probe                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87152  Culture type pulse field gel                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87153  Dna/rna sequencing                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87158  Culture typing added method                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87164  Dark field examination                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8716426Dark field examination                            A   0.37   0.17     0.18     0.17     0.18     0.03   0.57   0.58   0.57   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
87166  Dark field examination                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87168  Macroscopic exam arthropod                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87169  Macroscopic exam parasite                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87172  Pinworm exam                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87176  Tissue homogenization cultr                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87177  Ova and parasites smears                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87181  Microbe susceptible diffuse                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87184  Microbe susceptible disk                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87185  Microbe susceptible enzyme                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87186  Microbe susceptible mic                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87187  Microbe susceptible mlc                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87188  Microbe suscept macrobroth                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87190  Microbe suscept mycobacteri                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87197  Bactericidal level serum                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87205  Smear gram stain                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87206  Smear fluorescent/acid stai                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87207  Smear special stain                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8720726Smear special stain                               A   0.37   0.17     0.19     0.17     0.19     0.03   0.57   0.59   0.57   0.59  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
87209  Smear complex stain                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87210  Smear wet mount saline/ink                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87220  Tissue exam for fungi                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87230  Assay toxin or antitoxin                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87250  Virus inoculate eggs/animal                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87252  Virus inoculation tissue                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87253  Virus inoculate tissue addl                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87254  Virus inoculation shell via                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87255  Genet virus isolate hsv                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87260  Adenovirus ag if                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87265  Pertussis ag if                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87267  Enterovirus antibody dfa                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87269  Giardia ag if                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87270  Chlamydia trachomatis ag if                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87271  Cytomegalovirus dfa                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87272  Cryptosporidium ag if                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87273  Herpes simplex 2 ag if                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87274  Herpes simplex 1 ag if                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87275  Influenza b ag if                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87276  Influenza a ag if                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87277  Legionella micdadei ag if                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87278  Legion pneumophilia ag if                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87279  Parainfluenza ag if                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87280  Respiratory syncytial ag if                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87281  Pneumocystis carinii ag if                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87283  Rubeola ag if                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87285  Treponema pallidum ag if                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87290  Varicella zoster ag if                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87299  Antibody detection nos if                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87300  Ag detection polyval if                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87301  Adenovirus ag eia                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87305  Aspergillus ag eia                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87320  Chylmd trach ag eia                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87324  Clostridium ag eia                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87327  Cryptococcus neoform ag eia                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87328  Cryptosporidium ag eia                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87329  Giardia ag eia                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87332  Cytomegalovirus ag eia                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87335  E coli 0157 ag eia                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87336  Entamoeb hist dispr ag eia                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87337  Entamoeb hist group ag eia                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87338  Hpylori stool eia                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87339  H pylori ag eia                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87340  Hepatitis b surface ag eia                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87341  Hepatitis b surface ag eia                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87350  Hepatitis be ag eia                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87380  Hepatitis delta ag eia                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87385  Histoplasma capsul ag eia                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87390  Hiv-1 ag eia                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87391  Hiv-2 ag eia                                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87400  Influenza a/b ag eia                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87420  Resp syncytial ag eia                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87425  Rotavirus ag eia                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87427  Shiga-like toxin ag eia                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87430  Strep a ag eia                                    X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87449  Ag detect nos eia mult                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87450  Ag detect nos eia single                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87451  Ag detect polyval eia mult                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87470  Bartonella dna dir probe                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87471  Bartonella dna amp probe                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87472  Bartonella dna quant                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87475  Lyme dis dna dir probe                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87476  Lyme dis dna amp probe                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87477  Lyme dis dna quant                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87480  Candida dna dir probe                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87481  Candida dna amp probe                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87482  Candida dna quant                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87485  Chylmd pneum dna dir probe                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87486  Chylmd pneum dna amp probe                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87487  Chylmd pneum dna quant                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87490  Chylmd trach dna dir probe                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87491  Chylmd trach dna amp probe                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87492  Chylmd trach dna quant                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87493  C diff amplified probe                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87495  Cytomeg dna dir probe                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87496  Cytomeg dna amp probe                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87497  Cytomeg dna quant                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87498  Enterovirus dna amp probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87500  Vanomycin dna amp probe                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87501  Influenza dna amp prob 1+                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87502  Influenza dna amp probe                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87503  Influenza dna amp prob addl                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87510  Gardner vag dna dir probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87511  Gardner vag dna amp probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87512  Gardner vag dna quant                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87515  Hepatitis b dna dir probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87516  Hepatitis b dna amp probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87517  Hepatitis b dna quant                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87520  Hepatitis c rna dir probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87521  Hepatitis c rna amp probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87522  Hepatitis c rna quant                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87525  Hepatitis g dna dir probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87526  Hepatitis g dna amp probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87527  Hepatitis g dna quant                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87528  Hsv dna dir probe                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87529  Hsv dna amp probe                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87530  Hsv dna quant                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87531  Hhv-6 dna dir probe                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87532  Hhv-6 dna amp probe                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87533  Hhv-6 dna quant                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87534  Hiv-1 dna dir probe                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87535  Hiv-1 dna amp probe                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87536  Hiv-1 dna quant                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87537  Hiv-2 dna dir probe                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87538  Hiv-2 dna amp probe                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87539  Hiv-2 dna quant                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87540  Legion pneumo dna dir prob                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87541  Legion pneumo dna amp prob                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87542  Legion pneumo dna quant                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87550  Mycobacteria dna dir probe                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87551  Mycobacteria dna amp probe                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87552  Mycobacteria dna quant                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87555  M.tuberculo dna dir probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87556  M.tuberculo dna amp probe                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87557  M.tuberculo dna quant                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87560  M.avium-intra dna dir prob                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87561  M.avium-intra dna amp prob                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87562  M.avium-intra dna quant                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87580  M.pneumon dna dir probe                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87581  M.pneumon dna amp probe                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87582  M.pneumon dna quant                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87590  N.gonorrhoeae dna dir prob                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87591  N.gonorrhoeae dna amp prob                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87592  N.gonorrhoeae dna quant                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87620  Hpv dna dir probe                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87621  Hpv dna amp probe                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87622  Hpv dna quant                                     X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87640  Staph a dna amp probe                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87641  Mr-staph dna amp probe                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87650  Strep a dna dir probe                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87651  Strep a dna amp probe                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87652  Strep a dna quant                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87653  Strep b dna amp probe                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87660  Trichomonas vagin dir probe                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87797  Detect agent nos dna dir                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87798  Detect agent nos dna amp                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87799  Detect agent nos dna quant                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87800  Detect agnt mult dna direc                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87801  Detect agnt mult dna ampli                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87802  Strep b assay w/optic                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87803  Clostridium toxin a w/optic                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87804  Influenza assay w/optic                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87807  Rsv assay w/optic                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87808  Trichomonas assay w/optic                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87809  Adenovirus assay w/optic                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87810  Chylmd trach assay w/optic                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87850  N. gonorrhoeae assay w/optic                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87880  Strep a assay w/optic                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87899  Agent nos assay w/optic                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87900  Phenotype infect agent drug                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87901  Genotype dna hiv reverse t                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87902  Genotype dna hepatitis c                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87903  Phenotype dna hiv w/culture                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87904  Phenotype dna hiv w/clt add                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87905  Sialidase enzyme assay                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87906  Genotype dna hiv reverse t                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
87999  Microbiology procedure                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88000  Autopsy (necropsy) gross                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88005  Autopsy (necropsy) gross                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88007  Autopsy (necropsy) gross                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88012  Autopsy (necropsy) gross                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88014  Autopsy (necropsy) gross                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88016  Autopsy (necropsy) gross                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88020  Autopsy (necropsy) complete                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88025  Autopsy (necropsy) complete                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88027  Autopsy (necropsy) complete                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88028  Autopsy (necropsy) complete                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88029  Autopsy (necropsy) complete                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88036  Limited autopsy                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88037  Limited autopsy                                   N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88040  Forensic autopsy (necropsy)                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88045  Coroners autopsy (necropsy)                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88099  Necropsy (autopsy) procedure                      N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88104  Cytopath fl nongyn smears                         A   0.56   1.35     1.36     1.35NA   1.36 NA  0.02   1.93   1.94   1.93   1.94  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88104TCCytopath fl nongyn smears                         A   0.00   1.11     1.11     1.11NA   1.11 NA  0.01   1.12   1.12   1.12   1.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8810426Cytopath fl nongyn smears                         A   0.56   0.24     0.25     0.24     0.25     0.01   0.81   0.82   0.81   0.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88106  Cytopath fl nongyn filter                         A   0.56   1.78     1.74     1.78NA   1.74 NA  0.02   2.36   2.32   2.36   2.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88106TCCytopath fl nongyn filter                         A   0.00   1.55     1.49     1.55NA   1.49 NA  0.01   1.56   1.50   1.56   1.50  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8810626Cytopath fl nongyn filter                         A   0.56   0.23     0.25     0.23     0.25     0.01   0.80   0.82   0.80   0.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88107  Cytopath fl nongyn sm/fltr                        A   0.76   2.15     2.07     2.15NA   2.07 NA  0.04   2.95   2.87   2.95   2.87  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88107TCCytopath fl nongyn sm/fltr                        A   0.00   1.82     1.73     1.82NA   1.73 NA  0.01   1.83   1.74   1.83   1.74  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8810726Cytopath fl nongyn sm/fltr                        A   0.76   0.33     0.34     0.33     0.34     0.03   1.12   1.13   1.12   1.13  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88108  Cytopath concentrate tech                         A   0.56   1.64     1.59     1.64NA   1.59 NA  0.02   2.22   2.17   2.22   2.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88108TCCytopath concentrate tech                         A   0.00   1.41     1.35     1.41NA   1.35 NA  0.01   1.42   1.36   1.42   1.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8810826Cytopath concentrate tech                         A   0.56   0.23     0.24     0.23     0.24     0.01   0.80   0.81   0.80   0.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88112  Cytopath cell enhance tech                        A   1.18   1.80     1.67     1.80NA   1.67 NA  0.05   3.03   2.90   3.03   2.90  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88112TCCytopath cell enhance tech                        A   0.00   1.35     1.21     1.35NA   1.21 NA  0.01   1.36   1.22   1.36   1.22  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8811226Cytopath cell enhance tech                        A   1.18   0.45     0.46     0.45     0.46     0.04   1.67   1.68   1.67   1.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88120  Cytp urne 3-5 probes ea spec                      A   1.20  12.22    12.22    12.22NA  12.22 NA  0.05  13.47  13.47  13.47  13.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88120TCCytp urne 3-5 probes ea spec                      A   0.00  11.91    11.91    11.91NA  11.91 NA  0.02  11.93  11.93  11.93  11.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8812026Cytp urne 3-5 probes ea spec                      A   1.20   0.31     0.31     0.31     0.31     0.03   1.54   1.54   1.54   1.54  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88121  Cytp urine 3-5 probes cmptr                       A   1.00  10.34    10.34    10.34NA  10.34 NA  0.03  11.37  11.37  11.37  11.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88121TCCytp urine 3-5 probes cmptr                       A   0.00  10.00    10.00    10.00NA  10.00 NA  0.01  10.01  10.01  10.01  10.01  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8812126Cytp urine 3-5 probes cmptr                       A   1.00   0.34     0.34     0.34     0.34     0.02   1.36   1.36   1.36   1.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88125  Forensic cytopathology                            A   0.26   0.37     0.36     0.37NA   0.36 NA  0.02   0.65   0.64   0.65   0.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88125TCForensic cytopathology                            A   0.00   0.25     0.24     0.25NA   0.24 NA  0.01   0.26   0.25   0.26   0.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8812526Forensic cytopathology                            A   0.26   0.12     0.12     0.12     0.12     0.01   0.39   0.39   0.39   0.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88130  Sex chromatin identification                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88140  Sex chromatin identification                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88141  Cytopath c/v interpret                            A   0.42   0.40     0.42     0.40     0.42     0.03   0.85   0.87   0.85   0.87  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88142  Cytopath c/v thin layer                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88143  Cytopath c/v thin layer redo                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88147  Cytopath c/v automated                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88148  Cytopath c/v auto rescreen                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88150  Cytopath c/v manual                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88152  Cytopath c/v auto redo                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88153  Cytopath c/v redo                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88154  Cytopath c/v select                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88155  Cytopath c/v index add-on                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88160  Cytopath smear other source                       A   0.50   1.08     1.08     1.08NA   1.08 NA  0.02   1.60   1.60   1.60   1.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88160TCCytopath smear other source                       A   0.00   0.87     0.86     0.87NA   0.86 NA  0.01   0.88   0.87   0.88   0.87  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8816026Cytopath smear other source                       A   0.50   0.21     0.22     0.21     0.22     0.01   0.72   0.73   0.72   0.73  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88161  Cytopath smear other source                       A   0.50   1.08     1.01     1.08NA   1.01 NA  0.02   1.60   1.53   1.60   1.53  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88161TCCytopath smear other source                       A   0.00   0.89     0.82     0.89NA   0.82 NA  0.01   0.90   0.83   0.90   0.83  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8816126Cytopath smear other source                       A   0.50   0.19     0.19     0.19     0.19     0.01   0.70   0.70   0.70   0.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88162  Cytopath smear other source                       A   0.76   1.51     1.39     1.51NA   1.39 NA  0.04   2.31   2.19   2.31   2.19  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88162TCCytopath smear other source                       A   0.00   1.21     1.10     1.21NA   1.10 NA  0.01   1.22   1.11   1.22   1.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8816226Cytopath smear other source                       A   0.76   0.30     0.29     0.30     0.29     0.03   1.09   1.08   1.09   1.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88164  Cytopath tbs c/v manual                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88165  Cytopath tbs c/v redo                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88166  Cytopath tbs c/v auto redo                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88167  Cytopath tbs c/v select                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88172  Cytp dx eval fna 1st ea site                      A   0.60   0.87     0.76     0.87NA   0.76 NA  0.02   1.49   1.38   1.49   1.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88172TCCytp dx eval fna 1st ea site                      A   0.00   0.60     0.47     0.60NA   0.47 NA  0.01   0.61   0.48   0.61   0.48  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8817226Cytp dx eval fna 1st ea site                      A   0.60   0.27     0.29     0.27     0.29     0.01   0.88   0.90   0.88   0.90  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88173  Cytopath eval fna report                          A   1.39   2.62     2.56     2.62NA   2.56 NA  0.05   4.06   4.00   4.06   4.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88173TCCytopath eval fna report                          A   0.00   2.04     1.95     2.04NA   1.95 NA  0.01   2.05   1.96   2.05   1.96  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8817326Cytopath eval fna report                          A   1.39   0.58     0.61     0.58     0.61     0.04   2.01   2.04   2.01   2.04  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88174  Cytopath c/v auto in fluid                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88175  Cytopath c/v auto fluid redo                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88177  Cytp c/v auto thin lyr addl                       A   0.42   0.38     0.38     0.38NA   0.38 NA  0.02   0.82   0.82   0.82   0.82  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88177TCCytp c/v auto thin lyr addl                       A   0.00   0.18     0.18     0.18NA   0.18 NA  0.01   0.19   0.19   0.19   0.19  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8817726Cytp c/v auto thin lyr addl                       A   0.42   0.20     0.20     0.20     0.20     0.01   0.63   0.63   0.63   0.63  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88182  Cell marker study                                 A   0.77   2.24     2.08     2.24NA   2.08 NA  0.06   3.07   2.91   3.07   2.91  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88182TCCell marker study                                 A   0.00   2.02     1.86     2.02NA   1.86 NA  0.03   2.05   1.89   2.05   1.89  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8818226Cell marker study                                 A   0.77   0.22     0.22     0.22     0.22     0.03   1.02   1.02   1.02   1.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88184  Flowcytometry/ tc 1 marker                        A   0.00   2.47     2.30     2.47NA   2.30 NA  0.01   2.48   2.31   2.48   2.31  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88185  Flowcytometry/tc add-on                           A   0.00   1.48     1.40     1.48NA   1.40 NA  0.01   1.49   1.41   1.49   1.41  3ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88187  Flowcytometry/read 2-8                            A   1.36   0.55     0.59     0.55     0.59     0.08   1.99   2.03   1.99   2.03  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88188  Flowcytometry/read 9-15                           A   1.69   0.68     0.76     0.68     0.76     0.10   2.47   2.55   2.47   2.55  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88189  Flowcytometry/read 16 & >                         A   2.23   0.69     0.71     0.69     0.71     0.12   3.04   3.06   3.04   3.06  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88199  Cytopathology procedure                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88199TCCytopathology procedure                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8819926Cytopathology procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88230  Tissue culture lymphocyte                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88233  Tissue culture skin/biopsy                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88235  Tissue culture placenta                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88237  Tissue culture bone marrow                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88239  Tissue culture tumor                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88240  Cell cryopreserve/storage                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88241  Frozen cell preparation                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88245  Chromosome analysis 20-25                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88248  Chromosome analysis 50-100                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88249  Chromosome analysis 100                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88261  Chromosome analysis 5                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88262  Chromosome analysis 15-20                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88263  Chromosome analysis 45                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88264  Chromosome analysis 20-25                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88267  Chromosome analys placenta                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88269  Chromosome analys amniotic                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88271  Cytogenetics dna probe                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88272  Cytogenetics 3-5                                  X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88273  Cytogenetics 10-30                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88274  Cytogenetics 25-99                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88275  Cytogenetics 100-300                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88280  Chromosome karyotype study                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88283  Chromosome banding study                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88285  Chromosome count additional                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88289  Chromosome study additional                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88291  Cyto/molecular report                             A   0.52   0.31     0.31     0.31     0.31     0.03   0.86   0.86   0.86   0.86  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88299  Cytogenetic study                                 C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88300  Surgical path gross                               A   0.08   0.69     0.71     0.69NA   0.71 NA  0.02   0.79   0.81   0.79   0.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88300TCSurgical path gross                               A   0.00   0.65     0.67     0.65NA   0.67 NA  0.01   0.66   0.68   0.66   0.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8830026Surgical path gross                               A   0.08   0.04     0.04     0.04     0.04     0.01   0.13   0.13   0.13   0.13  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88302  Tissue exam by pathologist                        A   0.13   1.43     1.41     1.43NA   1.41 NA  0.02   1.58   1.56   1.58   1.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88302TCTissue exam by pathologist                        A   0.00   1.38     1.35     1.38NA   1.35 NA  0.01   1.39   1.36   1.39   1.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8830226Tissue exam by pathologist                        A   0.13   0.05     0.06     0.05     0.06     0.01   0.19   0.20   0.19   0.20  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88304  Tissue exam by pathologist                        A   0.22   1.61     1.44     1.61NA   1.44 NA  0.02   1.85   1.68   1.85   1.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88304TCTissue exam by pathologist                        A   0.00   1.52     1.34     1.52NA   1.34 NA  0.01   1.53   1.35   1.53   1.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8830426Tissue exam by pathologist                        A   0.22   0.09     0.10     0.09     0.10     0.01   0.32   0.33   0.32   0.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88305  Tissue exam by pathologist                        A   0.75   2.35     2.19     2.35NA   2.19 NA  0.02   3.12   2.96   3.12   2.96  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88305TCTissue exam by pathologist                        A   0.00   2.04     1.87     2.04NA   1.87 NA  0.01   2.05   1.88   2.05   1.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8830526Tissue exam by pathologist                        A   0.75   0.31     0.32     0.31     0.32     0.01   1.07   1.08   1.07   1.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88307  Tissue exam by pathologist                        A   1.59   5.04     5.09     5.04NA   5.09 NA  0.05   6.68   6.73   6.68   6.73  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88307TCTissue exam by pathologist                        A   0.00   4.33     4.34     4.33NA   4.34 NA  0.01   4.34   4.35   4.34   4.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8830726Tissue exam by pathologist                        A   1.59   0.71     0.75     0.71     0.75     0.04   2.34   2.38   2.34   2.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88309  Tissue exam by pathologist                        A   2.80   7.21     7.38     7.21NA   7.38 NA  0.11  10.12  10.29  10.12  10.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88309TCTissue exam by pathologist                        A   0.00   5.99     6.05     5.99NA   6.05 NA  0.03   6.02   6.08   6.02   6.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8830926Tissue exam by pathologist                        A   2.80   1.22     1.33     1.22     1.33     0.08   4.10   4.21   4.10   4.21  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88311  Decalcify tissue                                  A   0.24   0.29     0.30     0.29NA   0.30 NA  0.02   0.55   0.56   0.55   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88311TCDecalcify tissue                                  A   0.00   0.19     0.19     0.19NA   0.19 NA  0.01   0.20   0.20   0.20   0.20  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8831126Decalcify tissue                                  A   0.24   0.10     0.11     0.10     0.11     0.01   0.35   0.36   0.35   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88312  Special stains group 1                            A   0.54   2.59     2.53     2.59NA   2.53 NA  0.02   3.15   3.09   3.15   3.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88312TCSpecial stains group 1                            A   0.00   2.37     2.31     2.37NA   2.31 NA  0.01   2.38   2.32   2.38   2.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8831226Special stains group 1                            A   0.54   0.22     0.22     0.22     0.22     0.01   0.77   0.77   0.77   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88313  Special stains group 2                            A   0.24   2.04     1.97     2.04NA   1.97 NA  0.02   2.30   2.23   2.30   2.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88313TCSpecial stains group 2                            A   0.00   1.95     1.87     1.95NA   1.87 NA  0.01   1.96   1.88   1.96   1.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8831326Special stains group 2                            A   0.24   0.09     0.10     0.09     0.10     0.01   0.34   0.35   0.34   0.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88314  Histochemical stains add-on                       A   0.45   2.18     2.00     2.18NA   2.00 NA  0.02   2.65   2.47   2.65   2.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88314TCHistochemical stains add-on                       A   0.00   1.98     1.79     1.98NA   1.79 NA  0.01   1.99   1.80   1.99   1.80  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8831426Histochemical stains add-on                       A   0.45   0.20     0.21     0.20     0.21     0.01   0.66   0.67   0.66   0.67  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88318  Chemical histochemistry                           A   0.42   3.00     3.20     3.00NA   3.20 NA  0.02   3.44   3.64   3.44   3.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88318TCChemical histochemistry                           A   0.00   2.82     3.01     2.82NA   3.01 NA  0.01   2.83   3.02   2.83   3.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8831826Chemical histochemistry                           A   0.42   0.18     0.19     0.18     0.19     0.01   0.61   0.62   0.61   0.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88319  Enzyme histochemistry                             A   0.53   3.75     3.58     3.75NA   3.58 NA  0.04   4.32   4.15   4.32   4.15  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88319TCEnzyme histochemistry                             A   0.00   3.53     3.34     3.53NA   3.34 NA  0.01   3.54   3.35   3.54   3.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8831926Enzyme histochemistry                             A   0.53   0.22     0.24     0.22     0.24     0.03   0.78   0.80   0.78   0.80  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88321  Microslide consultation                           A   1.63   0.94     0.97     0.67     0.72     0.10   2.67   2.70   2.40   2.45  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88323  Microslide consultation                           A   1.83   2.33     2.17     2.33NA   2.17 NA  0.05   4.21   4.05   4.21   4.05  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88323TCMicroslide consultation                           A   0.00   1.73     1.57     1.73NA   1.57 NA  0.01   1.74   1.58   1.74   1.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8832326Microslide consultation                           A   1.83   0.60     0.60     0.60     0.60     0.04   2.47   2.47   2.47   2.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88325  Comprehensive review of data                      A   2.50   3.27     3.29     1.14     1.28     0.12   5.89   5.91   3.76   3.90  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88329  Path consult introp                               A   0.67   0.83     0.84     0.30     0.32     0.04   1.54   1.55   1.01   1.03  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88331  Path consult intraop 1 bloc                       A   1.19   1.49     1.52     1.49NA   1.52 NA  0.02   2.70   2.73   2.70   2.73  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88331TCPath consult intraop 1 bloc                       A   0.00   0.94     0.93     0.94NA   0.93 NA  0.01   0.95   0.94   0.95   0.94  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8833126Path consult intraop 1 bloc                       A   1.19   0.55     0.59     0.55     0.59     0.01   1.75   1.79   1.75   1.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88332  Path consult intraop addl                         A   0.59   0.58     0.59     0.58NA   0.59 NA  0.02   1.19   1.20   1.19   1.20  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88332TCPath consult intraop addl                         A   0.00   0.32     0.31     0.32NA   0.31 NA  0.01   0.33   0.32   0.33   0.32  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8833226Path consult intraop addl                         A   0.59   0.26     0.28     0.26     0.28     0.01   0.86   0.88   0.86   0.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88333  Intraop cyto path consult 1                       A   1.20   1.57     1.61     1.57NA   1.61 NA  0.05   2.82   2.86   2.82   2.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88333TCIntraop cyto path consult 1                       A   0.00   1.03     1.04     1.03NA   1.04 NA  0.01   1.04   1.05   1.04   1.05  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8833326Intraop cyto path consult 1                       A   1.20   0.54     0.57     0.54     0.57     0.04   1.78   1.81   1.78   1.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88334  Intraop cyto path consult 2                       A   0.73   0.97     1.00     0.97NA   1.00 NA  0.04   1.74   1.77   1.74   1.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88334TCIntraop cyto path consult 2                       A   0.00   0.64     0.65     0.64NA   0.65 NA  0.01   0.65   0.66   0.65   0.66  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8833426Intraop cyto path consult 2                       A   0.73   0.33     0.35     0.33     0.35     0.03   1.09   1.11   1.09   1.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88342  Immunohistochemistry                              A   0.85   2.18     2.12     2.18NA   2.12 NA  0.04   3.07   3.01   3.07   3.01  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88342TCImmunohistochemistry                              A   0.00   1.85     1.78     1.85NA   1.78 NA  0.01   1.86   1.79   1.86   1.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8834226Immunohistochemistry                              A   0.85   0.33     0.34     0.33     0.34     0.03   1.21   1.22   1.21   1.22  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88346  Immunofluorescent study                           A   0.86   2.13     2.04     2.13NA   2.04 NA  0.02   3.01   2.92   3.01   2.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88346TCImmunofluorescent study                           A   0.00   1.79     1.68     1.79NA   1.68 NA  0.01   1.80   1.69   1.80   1.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8834626Immunofluorescent study                           A   0.86   0.34     0.36     0.34     0.36     0.01   1.21   1.23   1.21   1.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88347  Immunofluorescent study                           A   0.86   1.41     1.27     1.41NA   1.27 NA  0.02   2.29   2.15   2.29   2.15  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88347TCImmunofluorescent study                           A   0.00   1.15     1.03     1.15NA   1.03 NA  0.01   1.16   1.04   1.16   1.04  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8834726Immunofluorescent study                           A   0.86   0.26     0.24     0.26     0.24     0.01   1.13   1.11   1.13   1.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88348  Electron microscopy                               A   1.51  18.48    17.96    18.48NA  17.96 NA  0.12  20.11  19.59  20.11  19.59  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88348TCElectron microscopy                               A   0.00  17.88    17.34    17.88NA  17.34 NA  0.08  17.96  17.42  17.96  17.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8834826Electron microscopy                               A   1.51   0.60     0.62     0.60     0.62     0.04   2.15   2.17   2.15   2.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88349  Scanning electron microscopy                      A   0.76   9.78    10.57     9.78NA  10.57 NA  0.07  10.61  11.40  10.61  11.40  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88349TCScanning electron microscopy                      A   0.00   9.43    10.19     9.43NA  10.19 NA  0.04   9.47  10.23   9.47  10.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8834926Scanning electron microscopy                      A   0.76   0.35     0.38     0.35     0.38     0.03   1.14   1.17   1.14   1.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88355  Analysis skeletal muscle                          A   1.85   4.41     3.23     4.41NA   3.23 NA  0.06   6.32   5.14   6.32   5.14  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88355TCAnalysis skeletal muscle                          A   0.00   3.84     2.69     3.84NA   2.69 NA  0.01   3.85   2.70   3.85   2.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8835526Analysis skeletal muscle                          A   1.85   0.57     0.54     0.57     0.54     0.05   2.47   2.44   2.47   2.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88356  Analysis nerve                                    A   3.02   5.15     4.51     5.15NA   4.51 NA  0.18   8.35   7.71   8.35   7.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88356TCAnalysis nerve                                    A   0.00   4.44     3.94     4.44NA   3.94 NA  0.04   4.48   3.98   4.48   3.98  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8835626Analysis nerve                                    A   3.02   0.71     0.57     0.71     0.57     0.14   3.87   3.73   3.87   3.73  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88358  Analysis tumor                                    A   0.95   1.21     1.16     1.21NA   1.16 NA  0.04   2.20   2.15   2.20   2.15  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88358TCAnalysis tumor                                    A   0.00   0.95     0.91     0.95NA   0.91 NA  0.01   0.96   0.92   0.96   0.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8835826Analysis tumor                                    A   0.95   0.26     0.25     0.26     0.25     0.03   1.24   1.23   1.24   1.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88360  Tumor immunohistochem/manual                      A   1.10   2.50     2.41     2.50NA   2.41 NA  0.04   3.64   3.55   3.64   3.55  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88360TCTumor immunohistochem/manual                      A   0.00   2.09     1.99     2.09NA   1.99 NA  0.01   2.10   2.00   2.10   2.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8836026Tumor immunohistochem/manual                      A   1.10   0.41     0.42     0.41     0.42     0.03   1.54   1.55   1.54   1.55  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88361  Tumor immunohistochem/comput                      A   1.18   3.24     3.02     3.24NA   3.02 NA  0.05   4.47   4.25   4.47   4.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88361TCTumor immunohistochem/comput                      A   0.00   2.82     2.58     2.82NA   2.58 NA  0.01   2.83   2.59   2.83   2.59  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8836126Tumor immunohistochem/comput                      A   1.18   0.42     0.44     0.42     0.44     0.04   1.64   1.66   1.64   1.66  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88362  Nerve teasing preparations                        A   2.17   6.03     6.06     6.03NA   6.06 NA  0.14   8.34   8.37   8.34   8.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88362TCNerve teasing preparations                        A   0.00   5.14     5.12     5.14NA   5.12 NA  0.04   5.18   5.16   5.18   5.16  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8836226Nerve teasing preparations                        A   2.17   0.89     0.94     0.89     0.94     0.10   3.16   3.21   3.16   3.21  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88363  Xm archive tissue molec anal                      A   0.37   0.72     0.72     0.10     0.10     0.03   1.12   1.12   0.50   0.50  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88365  Insitu hybridization (fish)                       A   1.20   3.65     3.57     3.65NA   3.57 NA  0.04   4.89   4.81   4.89   4.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88365TCInsitu hybridization (fish)                       A   0.00   3.19     3.10     3.19NA   3.10 NA  0.01   3.20   3.11   3.20   3.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8836526Insitu hybridization (fish)                       A   1.20   0.46     0.47     0.46     0.47     0.03   1.69   1.70   1.69   1.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88367  Insitu hybridization auto                         A   1.30   6.21     6.08     6.21NA   6.08 NA  0.06   7.57   7.44   7.57   7.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88367TCInsitu hybridization auto                         A   0.00   5.77     5.63     5.77NA   5.63 NA  0.01   5.78   5.64   5.78   5.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8836726Insitu hybridization auto                         A   1.30   0.44     0.45     0.44     0.45     0.05   1.79   1.80   1.79   1.80  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88368  Insitu hybridization manual                       A   1.40   5.04     4.83     5.04NA   4.83 NA  0.05   6.49   6.28   6.49   6.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88368TCInsitu hybridization manual                       A   0.00   4.65     4.47     4.65NA   4.47 NA  0.01   4.66   4.48   4.66   4.48  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8836826Insitu hybridization manual                       A   1.40   0.39     0.36     0.39     0.36     0.04   1.83   1.80   1.83   1.80  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88371  Protein western blot tissue                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8837126Protein western blot tissue                       A   0.37   0.16     0.18     0.16     0.18     0.03   0.56   0.58   0.56   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88372  Protein analysis w/probe                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8837226Protein analysis w/probe                          A   0.37   0.17     0.18     0.17     0.18     0.03   0.57   0.58   0.57   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88380  Microdissection laser                             A   1.56   3.56     2.61     3.56NA   2.61 NA  0.05   5.17   4.22   5.17   4.22  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88380TCMicrodissection laser                             A   0.00   3.03     2.16     3.03NA   2.16 NA  0.01   3.04   2.17   3.04   2.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8838026Microdissection laser                             A   1.56   0.53     0.45     0.53     0.45     0.04   2.13   2.05   2.13   2.05  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88381  Microdissection manual                            A   1.18   4.22     2.81     4.22NA   2.81 NA  0.04   5.44   4.03   5.44   4.03  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88381TCMicrodissection manual                            A   0.00   3.86     2.56     3.86NA   2.56 NA  0.01   3.87   2.57   3.87   2.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8838126Microdissection manual                            A   1.18   0.36     0.25     0.36     0.25     0.03   1.57   1.46   1.57   1.46  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88384  Eval molecular probes 11-50                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88384TCEval molecular probes 11-50                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8838426Eval molecular probes 11-50                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88385  Eval molecul probes 51-250                        A   1.50  15.40    15.14    15.40NA  15.14 NA  0.07  16.97  16.71  16.97  16.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88385TCEval molecul probes 51-250                        A   0.00  15.00    14.77    15.00NA  14.77 NA  0.03  15.03  14.80  15.03  14.80  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8838526Eval molecul probes 51-250                        A   1.50   0.40     0.37     0.40     0.37     0.04   1.94   1.91   1.94   1.91  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88386  Eval molecul probes 251-500                       A   1.88  16.95    13.92    16.95NA  13.92 NA  0.08  18.91  15.88  18.91  15.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88386TCEval molecul probes 251-500                       A   0.00  16.34    13.57    16.34NA  13.57 NA  0.03  16.37  13.60  16.37  13.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8838626Eval molecul probes 251-500                       A   1.88   0.61     0.35     0.61     0.35     0.05   2.54   2.28   2.54   2.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88387  Tiss exam molecular study                         A   0.62   0.55     0.55     0.55NA   0.55 NA  0.02   1.19   1.19   1.19   1.19  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88387TCTiss exam molecular study                         A   0.00   0.25     0.25     0.25NA   0.25 NA  0.01   0.26   0.26   0.26   0.26  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8838726Tiss exam molecular study                         A   0.62   0.30     0.30     0.30     0.30     0.01   0.93   0.93   0.93   0.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88388  Tiss ex molecul study add-on                      A   0.45   0.22     0.22     0.22NA   0.22 NA  0.02   0.69   0.69   0.69   0.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88388TCTiss ex molecul study add-on                      A   0.00   0.12     0.12     0.12NA   0.12 NA  0.01   0.13   0.13   0.13   0.13  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8838826Tiss ex molecul study add-on                      A   0.45   0.10     0.10     0.10     0.10     0.01   0.56   0.56   0.56   0.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88399  Surgical pathology procedure                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88399TCSurgical pathology procedure                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
8839926Surgical pathology procedure                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
88720  Bilirubin total transcut                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88738  Hgb quant transcutaneous                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88740  Transcutaneous carboxyhb                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88741  Transcutaneous methb                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
88749  In vivo lab service                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89049  Chct for mal hyperthermia                         A   1.40   6.02     5.82     0.46     0.40     0.10   7.52   7.32   1.96   1.90  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
89050  Body fluid cell count                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89051  Body fluid cell count                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89055  Leukocyte assessment fecal                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89060  Exam synovial fluid crystals                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
8906026Exam synovial fluid crystals                      A   0.37   0.17     0.18     0.17     0.18     0.03   0.57   0.58   0.57   0.58  6XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
89125  Specimen fat stain                                X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89160  Exam feces for meat fibers                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89190  Nasal smear for eosinophils                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89220  Sputum specimen collection                        A   0.00   0.46     0.44     0.46NA   0.44 NA  0.01   0.47   0.45   0.47   0.45  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
89230  Collect sweat for test                            A   0.00   0.08     0.06     0.08NA   0.06 NA  0.01   0.09   0.07   0.09   0.07  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
89240  Pathology lab procedure                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
89250  Cultr oocyte/embryo <4 days                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89251  Cultr oocyte/embryo <4 days                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89253  Embryo hatching                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89254  Oocyte identification                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89255  Prepare embryo for transfer                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89257  Sperm identification                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89258  Cryopreservation embryo(s)                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89259  Cryopreservation sperm                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89260  Sperm isolation simple                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89261  Sperm isolation complex                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89264  Identify sperm tissue                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89268  Insemination of oocytes                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89272  Extended culture of oocytes                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89280  Assist oocyte fertilization                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89281  Assist oocyte fertilization                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89290  Biopsy oocyte polar body                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89291  Biopsy oocyte polar body                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89300  Semen analysis w/huhner                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89310  Semen analysis w/count                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89320  Semen anal vol/count/mot                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89321  Semen anal sperm detection                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89322  Semen anal strict criteria                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89325  Sperm antibody test                               X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89329  Sperm evaluation test                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89330  Evaluation cervical mucus                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89331  Retrograde ejaculation anal                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89335  Cryopreserve testicular tiss                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89342  Storage/year embryo(s)                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89343  Storage/year sperm/semen                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89344  Storage/year reprod tissue                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89346  Storage/year oocyte(s)                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89352  Thawing cryopresrved embryo                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89353  Thawing cryopresrved sperm                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89354  Thaw cryoprsvrd reprod tiss                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89356  Thawing cryopresrved oocyte                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
89398  Unlisted reprod med lab proc                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90281  Human ig im                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90283  Human ig iv                                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90284  Human ig sc                                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90287  Botulinum antitoxin                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90288  Botulism ig iv                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90291  Cmv ig iv                                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90296  Diphtheria antitoxin                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90371  Hep b ig im                                       E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90375  Rabies ig im/sc                                   E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90376  Rabies ig heat treated                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90378  Rsv mab im 50mg                                   X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90384  Rh ig full-dose im                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90385  Rh ig minidose im                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90386  Rh ig iv                                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90389  Tetanus ig im                                     I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90393  Vaccina ig im                                     E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90396  Varicella-zoster ig im                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90399  Immune globulin                                   I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90460  Imadm any route 1st vac/tox                       A   0.17   0.50     0.50     0.50NA   0.50 NA  0.01   0.68   0.68   0.68   0.68  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90461  Inadm any route addl vac/tox                      A   0.15   0.18     0.20     0.18NA   0.20 NA  0.01   0.34   0.36   0.34   0.36  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90470  Immune admin H1N1 im/nasal                        I+  0.20   0.40     0.40     0.40NA   0.40 NA  0.01   0.61   0.61   0.61   0.61  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90471  Immunization admin                                A   0.17   0.50     0.50     0.50NA   0.50 NA  0.01   0.68   0.68   0.68   0.68  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90472  Immunization admin each add                       A   0.15   0.18     0.20     0.18NA   0.20 NA  0.01   0.34   0.36   0.34   0.36  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90473  Immune admin oral/nasal                           R   0.17   0.50     0.50     0.50NA   0.50 NA  0.01   0.68   0.68   0.68   0.68  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90474  Immune admin oral/nasal addl                      R   0.15   0.18     0.20     0.18NA   0.20 NA  0.01   0.34   0.36   0.34   0.36  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90476  Adenovirus vaccine type 4                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90477  Adenovirus vaccine type 7                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90581  Anthrax vaccine sc                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90585  Bcg vaccine percut                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90586  Bcg vaccine intravesical                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90632  Hep a vaccine adult im                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90633  Hep a vacc ped/adol 2 dose                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90634  Hep a vacc ped/adol 3 dose                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90636  Hep a/hep b vacc adult im                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90644  Meningoccl hib vac 4 dose im                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90645  Hib vaccine hboc im                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90646  Hib vaccine prp-d im                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90647  Hib vaccine prp-omp im                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90648  Hib vaccine prp-t im                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90649  Hpv vaccine 4 valent im                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90650  Hpv vaccine 2 valent im                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90654  Flu vaccine no preserv, ID                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90655  Flu vaccine no preserv 6-35m                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90656  Flu vaccine no preserv 3 & >                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90657  Flu vaccine 3 yrs im                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90658  Flu vaccine 3 yrs & > im                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90660  Flu vaccine nasal                                 X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90661  Flu vacc cell cult prsv free                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90662  Flu vacc prsv free inc antig                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90663  Flu vacc pandemic H1N1                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90664  Flu vacc pandemic intranasal                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90665  Lyme disease vaccine im                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90666  Flu vac pandem prsrv free im                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90667  Flu vac pandemic adjuvant im                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90668  Flu vac pandemic splt im                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90669  Pneumococcal vacc 7 val im                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90670  Pneumococcal vacc 13 val im                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90675  Rabies vaccine im                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90676  Rabies vaccine id                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90680  Rotovirus vacc 3 dose oral                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90681  Rotavirus vacc 2 dose oral                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90690  Typhoid vaccine oral                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90691  Typhoid vaccine im                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90692  Typhoid vaccine h-p sc/id                         E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90693  Typhoid vaccine akd sc                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90696  Dtap-ipv vacc 4-6 yr im                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90698  Dtap-hib-ip vaccine im                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90700  Dtap vaccine < 7 yrs im                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90701  Dtp vaccine im                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90702  Dt vaccine < 7 im                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90703  Tetanus vaccine im                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90704  Mumps vaccine sc                                  E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90705  Measles vaccine sc                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90706  Rubella vaccine sc                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90707  Mmr vaccine sc                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90708  Measles-rubella vaccine sc                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90710  Mmrv vaccine sc                                   E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90712  Oral poliovirus vaccine                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90713  Poliovirus ipv sc/im                              E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90714  Td vaccine no prsrv >/= 7 im                      E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90715  Tdap vaccine >7 im                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90716  Chicken pox vaccine sc                            E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90717  Yellow fever vaccine sc                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90718  Td vaccine > 7 im                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90719  Diphtheria vaccine im                             E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90720  Dtp/hib vaccine im                                E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90721  Dtap/hib vaccine im                               E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90723  Dtap-hep b-ipv vaccine im                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90725  Cholera vaccine injectable                        E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90727  Plague vaccine im                                 E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90732  Pneumococcal vaccine                              X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90733  Meningococcal vaccine sc                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90734  Meningococcal vaccine im                          E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90735  Encephalitis vaccine sc                           E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90736  Zoster vacc sc                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90738  Inactivated je vacc im                            I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90740  Hepb vacc ill pat 3 dose im                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90743  Hep b vacc adol 2 dose im                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90744  Hepb vacc ped/adol 3 dose im                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90746  Hep b vaccine adult im                            X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90747  Hepb vacc ill pat 4 dose im                       X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90748  Hep b/hib vaccine im                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90749  Vaccine toxoid                                    E   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90801  Psy dx interview                                  A   2.80   1.62     1.55     0.72     0.60     0.11   4.53   4.46   3.63   3.51  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90802  Intac psy dx interview                            A   3.01   1.80     1.83     0.84     0.78     0.12   4.93   4.96   3.97   3.91  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90804  Psytx office 20-30 min                            A   1.21   0.61     0.57     0.25     0.18     0.04   1.86   1.82   1.50   1.43  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90805  Psytx off 20-30 min w/e&m                         A   1.37   0.70     0.70     0.32     0.28     0.05   2.12   2.12   1.74   1.70  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90806  Psytx off 45-50 min                               A   1.86   0.58     0.46     0.37     0.25     0.07   2.51   2.39   2.30   2.18  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90807  Psytx off 45-50 min w/e&m                         A   2.02   0.85     0.83     0.47     0.42     0.08   2.95   2.93   2.57   2.52  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90808  Psytx office 75-80 min                            A   2.79   0.79     0.63     0.59     0.43     0.10   3.68   3.52   3.48   3.32  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90809  Psytx off 75-80 w/e&m                             A   2.95   1.07     1.03     0.71     0.64     0.12   4.14   4.10   3.78   3.71  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90810  Intac psytx off 20-30 min                         A   1.32   0.56     0.48     0.27     0.21     0.05   1.93   1.85   1.64   1.58  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90811  Intac psytx 20-30 w/e&m                           A   1.48   0.84     0.87     0.36     0.32     0.07   2.39   2.42   1.91   1.87  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90812  Intac psytx off 45-50 min                         A   1.97   0.70     0.57     0.39     0.26     0.07   2.74   2.61   2.43   2.30  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90813  Intac psytx 45-50 min w/e&m                       A   2.13   0.98     0.97     0.50     0.43     0.08   3.19   3.18   2.71   2.64  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90814  Intac psytx off 75-80 min                         A   2.90   0.94     0.74     0.62     0.38     0.11   3.95   3.75   3.63   3.39  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90815  Intac psytx 75-80 w/e&m                           A   3.06   1.30     1.35     0.82     0.82     0.14   4.50   4.55   4.02   4.02  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90816  Psytx hosp 20-30 min                              A   1.25   0.26     0.26     0.35     0.26     0.04   1.55   1.55   1.64   1.55  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90817  Psytx hosp 20-30 min w/e&m                        A   1.41   0.41     0.41     0.44     0.41     0.05   1.87   1.87   1.90   1.87  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90818  Psytx hosp 45-50 min                              A   1.89   0.34     0.34     0.48     0.34     0.07   2.30   2.30   2.44   2.30  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90819  Psytx hosp 45-50 min w/e&m                        A   2.05   0.55     0.55     0.60     0.55     0.08   2.68   2.68   2.73   2.68  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90821  Psytx hosp 75-80 min                              A   2.83   0.48     0.48     0.67     0.48     0.10   3.41   3.41   3.60   3.41  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90822  Psytx hosp 75-80 min w/e&m                        A   2.99   0.74     0.74     0.81     0.74     0.12   3.85   3.85   3.92   3.85  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90823  Intac psytx hosp 20-30 min                        A   1.36   0.29     0.29     0.38     0.29     0.04   1.69   1.69   1.78   1.69  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90824  Intac psytx hsp 20-30 w/e&m                       A   1.52   0.43     0.43     0.47     0.43     0.07   2.02   2.02   2.06   2.02  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90826  Intac psytx hosp 45-50 min                        A   2.01   0.38     0.38     0.51     0.38     0.07   2.46   2.46   2.59   2.46  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90827  Intac psytx hsp 45-50 w/e&m                       A   2.16   0.56     0.56     0.61     0.56     0.08   2.80   2.80   2.85   2.80  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90828  Intac psytx hosp 75-80 min                        A   2.94   0.51     0.51     0.71     0.51     0.10   3.55   3.55   3.75   3.55  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90829  Intac psytx hsp 75-80 w/e&m                       A   3.10   0.75     0.75     0.83     0.75     0.12   3.97   3.97   4.05   3.97  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90845  Psychoanalysis                                    A   1.79   0.48     0.43     0.42     0.36     0.07   2.34   2.29   2.28   2.22  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90846  Family psytx w/o patient                          R   1.83   0.58     0.49     0.50     0.40     0.07   2.48   2.39   2.40   2.30  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90847  Family psytx w/patient                            R   2.21   0.81     0.70     0.57     0.44     0.08   3.10   2.99   2.86   2.73  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90849  Multiple family group psytx                       R   0.59   0.38     0.39     0.25     0.22     0.03   1.00   1.01   0.87   0.84  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90853  Group psychotherapy                               A   0.59   0.32     0.33     0.25     0.25     0.03   0.94   0.95   0.87   0.87  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90857  Intac group psytx                                 A   0.63   0.43     0.44     0.29     0.30     0.03   1.09   1.10   0.95   0.96  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90862  Medication management                             A   0.95   0.71     0.73     0.33     0.32     0.04   1.70   1.72   1.32   1.31  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90865  Narcosynthesis                                    A   2.84   1.70     1.77     0.80     0.70     0.11   4.65   4.72   3.75   3.65  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90867  Tcranial magn stim tx plan                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90868  Tcranial magn stim tx deli                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90870  Electroconvulsive therapy                         A   2.50   2.31     2.33     0.56     0.58     0.11   4.92   4.94   3.17   3.19  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90875  Psychophysiological therapy                       N+  1.20   0.87     0.84     0.52     0.53     0.08   2.15   2.12   1.80   1.81  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90876  Psychophysiological therapy                       N+  1.90   1.15     1.13     0.82     0.84     0.12   3.17   3.15   2.84   2.86  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90880  Hypnotherapy                                      A   2.19   0.69     0.53     0.47     0.36     0.08   2.96   2.80   2.74   2.63  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90882  Environmental manipulation                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90885  Psy evaluation of records                         B+  0.97   0.42     0.43     0.42     0.43     0.07   1.46   1.47   1.46   1.47  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90887  Consultation with family                          B+  1.48   0.99     0.99     0.64     0.65     0.10   2.57   2.57   2.22   2.23  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90889  Preparation of report                             B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90899  Psychiatric service/therapy                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90901  Biofeedback train any meth                        A   0.41   0.66     0.70     0.17     0.19     0.01   1.08   1.12   0.59   0.61  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90911  Biofeedback peri/uro/rectal                       A   0.89   1.61     1.47     0.38     0.37     0.07   2.57   2.43   1.34   1.33  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90935  Hemodialysis one evaluation                       A   1.48   0.64NA   0.57NA   0.64     0.57     0.08   2.20   2.13   2.20   2.13  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90937  Hemodialysis repeated eval                        A   2.11   0.93NA   0.82NA   0.93     0.82     0.11   3.15   3.04   3.15   3.04  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90940  Hemodialysis access study                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90945  Dialysis one evaluation                           A   1.56   0.66     0.60     0.66NA   0.60 NA  0.08   2.30   2.24   2.30   2.24  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90947  Dialysis repeated eval                            A   2.52   1.01NA   0.97NA   1.01     0.97     0.15   3.68   3.64   3.68   3.64  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90951  Esrd serv 4 visits p mo <2                        A  18.46   8.68     8.04     8.68     8.04     1.02  28.16  27.52  28.16  27.52  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90952  Esrd serv 2-3 vsts p mo <2                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90953  Esrd serv 1 visit p mo <2                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90954  Esrd serv 4 vsts p mo 2-11                        A  15.98   6.74     6.95     6.74     6.95     0.90  23.62  23.83  23.62  23.83  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90955  Esrd srv 2-3 vsts p mo 2-11                       A   8.79   4.07     4.09     4.07     4.09     0.49  13.35  13.37  13.35  13.37  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90956  Esrd srv 1 visit p mo 2-11                        A   5.95   2.87     2.99     2.87     2.99     0.34   9.16   9.28   9.16   9.28  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90957  Esrd srv 4 vsts p mo 12-19                        A  12.52   5.65     5.62     5.65     5.62     0.72  18.89  18.86  18.89  18.86  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90958  Esrd srv 2-3 vsts p mo 12-19                      A   8.34   3.98     3.99     3.98     3.99     0.48  12.80  12.81  12.80  12.81  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90959  Esrd serv 1 vst p mo 12-19                        A   5.50   2.71     2.84     2.71     2.84     0.31   8.52   8.65   8.52   8.65  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90960  Esrd srv 4 visits p mo 20+                        A   5.18   2.91     2.80     2.91     2.80     0.31   8.40   8.29   8.40   8.29  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90961  Esrd srv 2-3 vsts p mo 20+                        A   4.26   2.39     2.45     2.39     2.45     0.26   6.91   6.97   6.91   6.97  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90962  Esrd serv 1 visit p mo 20+                        A   3.15   1.81     2.02     1.81     2.02     0.20   5.16   5.37   5.16   5.37  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90963  Esrd home pt serv p mo <2                         A  10.56   4.93     4.78     4.93     4.78     0.60  16.09  15.94  16.09  15.94  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90964  Esrd home pt serv p mo 2-11                       A   9.14   4.01     4.23     4.01     4.23     0.52  13.67  13.89  13.67  13.89  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90965  Esrd home pt serv p mo 12-19                      A   8.69   3.85     4.06     3.85     4.06     0.49  13.03  13.24  13.03  13.24  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90966  Esrd home pt serv p mo 20+                        A   4.26   2.35     2.44     2.35     2.44     0.26   6.87   6.96   6.87   6.96  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90967  Esrd home pt serv p day <2                        A   0.35   0.19     0.16     0.19     0.16     0.01   0.55   0.52   0.55   0.52  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90968  Esrd home pt srv p day 2-11                       A   0.30   0.14     0.14     0.14     0.14     0.01   0.45   0.45   0.45   0.45  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90969  Esrd home pt srv p day 12-19                      A   0.29   0.14     0.14     0.14     0.14     0.01   0.44   0.44   0.44   0.44  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90970  Esrd home pt serv p day 20+                       A   0.14   0.08     0.08     0.08     0.08     0.01   0.23   0.23   0.23   0.23  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90989  Dialysis training complete                        X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90993  Dialysis training incompl                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
90997  Hemoperfusion                                     A   1.84   0.69NA   0.69NA   0.69     0.69     0.10   2.63   2.63   2.63   2.63  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
90999  Dialysis procedure                                C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91010  Esophagus motility study                          A   1.28   4.17     3.73     4.17NA   3.73 NA  0.08   5.53   5.09   5.53   5.09  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91010TCEsophagus motility study                          A   0.00   3.49     3.04     3.49NA   3.04 NA  0.01   3.50   3.05   3.50   3.05  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9101026Esophagus motility study                          A   1.28   0.68     0.69     0.68     0.69     0.07   2.03   2.04   2.03   2.04  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91013  Esophgl motil w/stim/perfus                       A   0.18   0.48     0.48     0.48NA   0.48 NA  0.02   0.68   0.68   0.68   0.68  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91013TCEsophgl motil w/stim/perfus                       A   0.00   0.38     0.38     0.38NA   0.38 NA  0.01   0.39   0.39   0.39   0.39  1ZZZ.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9101326Esophgl motil w/stim/perfus                       A   0.18   0.10     0.10     0.10     0.10     0.01   0.29   0.29   0.29   0.29  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91020  Gastric motility studies                          A   1.44   5.49     5.24     5.49NA   5.24 NA  0.08   7.01   6.76   7.01   6.76  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91020TCGastric motility studies                          A   0.00   4.72     4.46     4.72NA   4.46 NA  0.01   4.73   4.47   4.73   4.47  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9102026Gastric motility studies                          A   1.44   0.77     0.78     0.77     0.78     0.07   2.28   2.29   2.28   2.29  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91022  Duodenal motility study                           A   1.44   3.92     3.47     3.92NA   3.47 NA  0.06   5.42   4.97   5.42   4.97  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91022TCDuodenal motility study                           A   0.00   3.10     2.66     3.10NA   2.66 NA  0.01   3.11   2.67   3.11   2.67  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9102226Duodenal motility study                           A   1.44   0.82     0.81     0.82     0.81     0.05   2.31   2.30   2.31   2.30  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91030  Acid perfusion of esophagus                       A   0.91   3.20     3.02     3.20NA   3.02 NA  0.05   4.16   3.98   4.16   3.98  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91030TCAcid perfusion of esophagus                       A   0.00   2.69     2.51     2.69NA   2.51 NA  0.01   2.70   2.52   2.70   2.52  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9103026Acid perfusion of esophagus                       A   0.91   0.51     0.51     0.51     0.51     0.04   1.46   1.46   1.46   1.46  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91034  Gastroesophageal reflux test                      A   0.97   4.82     4.40     4.82NA   4.40 NA  0.05   5.84   5.42   5.84   5.42  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91034TCGastroesophageal reflux test                      A   0.00   4.31     3.87     4.31NA   3.87 NA  0.01   4.32   3.88   4.32   3.88  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9103426Gastroesophageal reflux test                      A   0.97   0.51     0.53     0.51     0.53     0.04   1.52   1.54   1.52   1.54  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91035  G-esoph reflx tst w/electrod                      A   1.59  12.70    12.02    12.70NA  12.02 NA  0.08  14.37  13.69  14.37  13.69  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91035TCG-esoph reflx tst w/electrod                      A   0.00  11.85    11.16    11.85NA  11.16 NA  0.01  11.86  11.17  11.86  11.17  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9103526G-esoph reflx tst w/electrod                      A   1.59   0.85     0.86     0.85     0.86     0.07   2.51   2.52   2.51   2.52  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91037  Esoph imped function test                         A   0.97   3.78     3.60     3.78NA   3.60 NA  0.08   4.83   4.65   4.83   4.65  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91037TCEsoph imped function test                         A   0.00   3.25     3.07     3.25NA   3.07 NA  0.01   3.26   3.08   3.26   3.08  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9103726Esoph imped function test                         A   0.97   0.53     0.53     0.53     0.53     0.07   1.57   1.57   1.57   1.57  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91038  Esoph imped funct test > 1h                       A   1.10   7.67    12.00     7.67NA  12.00 NA  0.06   8.83  13.16   8.83  13.16  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91038TCEsoph imped funct test > 1h                       A   0.00   7.07    11.40     7.07NA  11.40 NA  0.01   7.08  11.41   7.08  11.41  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9103826Esoph imped funct test > 1h                       A   1.10   0.60     0.60     0.60     0.60     0.05   1.75   1.75   1.75   1.75  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91040  Esoph balloon distension tst                      A   0.97   9.13     7.09     9.13NA   7.09 NA  0.04  10.14   8.10  10.14   8.10  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91040TCEsoph balloon distension tst                      A   0.00   8.65     6.71     8.65NA   6.71 NA  0.01   8.66   6.72   8.66   6.72  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9104026Esoph balloon distension tst                      A   0.97   0.48     0.38     0.48     0.38     0.03   1.48   1.38   1.48   1.38  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91065  Breath hydrogen test                              A   0.20   2.13     2.36     2.13NA   2.36 NA  0.02   2.35   2.58   2.35   2.58  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91065TCBreath hydrogen test                              A   0.00   2.03     2.25     2.03NA   2.25 NA  0.01   2.04   2.26   2.04   2.26  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9106526Breath hydrogen test                              A   0.20   0.10     0.11     0.10     0.11     0.01   0.31   0.32   0.31   0.32  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91110  Gi tract capsule endoscopy                        A   3.64  23.37    21.61    23.37NA  21.61 NA  0.17  27.18  25.42  27.18  25.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91110TCGi tract capsule endoscopy                        A   0.00  21.36    19.59    21.36NA  19.59 NA  0.01  21.37  19.60  21.37  19.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9111026Gi tract capsule endoscopy                        A   3.64   2.01     2.02     2.01     2.02     0.16   5.81   5.82   5.81   5.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91111  Esophageal capsule endoscopy                      A   1.00  20.72    19.45    20.72NA  19.45 NA  0.05  21.77  20.50  21.77  20.50  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91111TCEsophageal capsule endoscopy                      A   0.00  20.15    18.90    20.15NA  18.90 NA  0.01  20.16  18.91  20.16  18.91  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9111126Esophageal capsule endoscopy                      A   1.00   0.57     0.55     0.57     0.55     0.04   1.61   1.59   1.61   1.59  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91117  Colon motility 6 hr study                         A   2.45   1.36     1.36     1.64     1.64     0.38   4.19   4.19   4.47   4.47  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91120  Rectal sensation test                             A   0.97  10.31     9.11    10.31NA   9.11 NA  0.09  11.37  10.17  11.37  10.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91120TCRectal sensation test                             A   0.00   9.89     8.66     9.89NA   8.66 NA  0.01   9.90   8.67   9.90   8.67  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9112026Rectal sensation test                             A   0.97   0.42     0.45     0.42     0.45     0.08   1.47   1.50   1.47   1.50  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91122  Anal pressure record                              A   1.77   4.86     4.46     4.86NA   4.46 NA  0.11   6.74   6.34   6.74   6.34  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91122TCAnal pressure record                              A   0.00   4.09     3.67     4.09NA   3.67 NA  0.01   4.10   3.68   4.10   3.68  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9112226Anal pressure record                              A   1.77   0.77     0.79     0.77     0.79     0.10   2.64   2.66   2.64   2.66  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91132  Electrogastrography                               A   0.52   3.62     3.61     3.62NA   3.61 NA  0.04   4.18   4.17   4.18   4.17  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
91132TCElectrogastrography                               A   0.00   3.34     3.34     3.34NA   3.34 NA  0.01   3.35   3.35   3.35   3.35  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9113226Electrogastrography                               A   0.52   0.28     0.27     0.28     0.27     0.03   0.83   0.82   0.83   0.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91133  Electrogastrography w/test                        A   0.66   4.40     4.39     4.40NA   4.39 NA  0.05   5.11   5.10   5.11   5.10  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91133TCElectrogastrography w/test                        A   0.00   4.02     4.02     4.02NA   4.02 NA  0.01   4.03   4.03   4.03   4.03  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9113326Electrogastrography w/test                        A   0.66   0.38     0.37     0.38     0.37     0.04   1.08   1.07   1.08   1.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91299  Gastroenterology procedure                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
91299TCGastroenterology procedure                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9129926Gastroenterology procedure                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92002  Eye exam new patient                              A   0.88   1.28     1.37     0.43     0.49     0.07   2.23   2.32   1.38   1.44  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92004  Eye exam new patient                              A   1.82   2.19     2.37     0.92     1.05     0.12   4.13   4.31   2.86   2.99  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92012  Eye exam established pat                          A   0.92   1.37     1.48     0.51     0.60     0.07   2.36   2.47   1.50   1.59  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92014  Eye exam & treatment                              A   1.42   1.90     2.06     0.76     0.89     0.10   3.42   3.58   2.28   2.41  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92015  Refraction                                        N+  0.38   0.38     0.18     0.16     0.17     0.03   0.79   0.59   0.57   0.58  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92018  New eye exam & treatment                          A   2.50   1.43NA   1.66NA   1.43     1.66     0.16   4.09   4.32   4.09   4.32  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92019  Eye exam & treatment                              A   1.31   0.60NA   0.67NA   0.60     0.67     0.07   1.98   2.05   1.98   2.05  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92020  Special eye evaluation                            A   0.37   0.37     0.40     0.21     0.24     0.03   0.77   0.80   0.61   0.64  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92025  Corneal topography                                A   0.35   0.66     0.71     0.66NA   0.71 NA  0.02   1.03   1.08   1.03   1.08  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92025TCCorneal topography                                A   0.00   0.46     0.48     0.46NA   0.48 NA  0.01   0.47   0.49   0.47   0.49  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
9202526Corneal topography                                A   0.35   0.20     0.23     0.20     0.23     0.01   0.56   0.59   0.56   0.59  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92060  Special eye evaluation                            A   0.69   1.05     1.14     1.05NA   1.14 NA  0.04   1.78   1.87   1.78   1.87  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92060TCSpecial eye evaluation                            A   0.00   0.67     0.71     0.67NA   0.71 NA  0.01   0.68   0.72   0.68   0.72  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9206026Special eye evaluation                            A   0.69   0.38     0.43     0.38     0.43     0.03   1.10   1.15   1.10   1.15  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92065  Orthoptic/pleoptic training                       A   0.37   1.04     1.13     1.04NA   1.13 NA  0.02   1.43   1.52   1.43   1.52  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92065TCOrthoptic/pleoptic training                       A   0.00   0.90     0.98     0.90NA   0.98 NA  0.01   0.91   0.99   0.91   0.99  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9206526Orthoptic/pleoptic training                       A   0.37   0.14     0.15     0.14     0.15     0.01   0.52   0.53   0.52   0.53  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92070  Fitting of contact lens                           A   0.70   1.24     1.30     0.37     0.43     0.04   1.98   2.04   1.11   1.17  0XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
92081  Visual field examination(s)                       A   0.30   1.10     1.03     1.10NA   1.03 NA  0.03   1.43   1.36   1.43   1.36  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92081TCVisual field examination(s)                       A   0.00   0.93     0.86     0.93NA   0.86 NA  0.01   0.94   0.87   0.94   0.87  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9208126Visual field examination(s)                       A   0.30   0.17     0.17     0.17     0.17     0.02   0.49   0.49   0.49   0.49  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92082  Visual field examination(s)                       A   0.40   1.55     1.51     1.55NA   1.51 NA  0.05   2.00   1.96   2.00   1.96  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92082TCVisual field examination(s)                       A   0.00   1.34     1.28     1.34NA   1.28 NA  0.01   1.35   1.29   1.35   1.29  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9208226Visual field examination(s)                       A   0.40   0.21     0.23     0.21     0.23     0.04   0.65   0.67   0.65   0.67  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92083  Visual field examination(s)                       A   0.50   1.95     2.06     1.95NA   2.06 NA  0.04   2.49   2.60   2.49   2.60  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92083TCVisual field examination(s)                       A   0.00   1.67     1.74     1.67NA   1.74 NA  0.01   1.68   1.75   1.68   1.75  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9208326Visual field examination(s)                       A   0.50   0.28     0.32     0.28     0.32     0.03   0.81   0.85   0.81   0.85  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92100  Serial tonometry exam(s)                          A   0.92   1.70     1.82     0.47     0.55     0.05   2.67   2.79   1.44   1.52  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92120  Tonography & eye evaluation                       A   0.81   1.32     1.40     0.41     0.47     0.05   2.18   2.26   1.27   1.33  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92130  Water provocation tonography                      A   0.81   1.57     1.67     0.45     0.51     0.04   2.42   2.52   1.30   1.36  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92132  Cmptr ophth dx img ant segmt                      A   0.35   0.68     0.68     0.68NA   0.68 NA  0.04   1.07   1.07   1.07   1.07  1XXX.00.00.0002000             25.5217 090 99      1.84   1.84   0.07
92132TCCmptr ophth dx img ant segmt                      A   0.00   0.44     0.44     0.44NA   0.44 NA  0.01   0.45   0.45   0.45   0.45  1XXX.00.00.0002000             25.5217 010 99      1.60   1.60   0.04
9213226Cmptr ophth dx img ant segmt                      A   0.35   0.24     0.24     0.24     0.24     0.03   0.62   0.62   0.62   0.62  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92133  Cmptr ophth img optic nerve                       A   0.50   0.77     0.77     0.77NA   0.77 NA  0.04   1.31   1.31   1.31   1.31  1XXX.00.00.0002000             25.5217 090 99      1.93   1.93   0.07
92133TCCmptr ophth img optic nerve                       A   0.00   0.44     0.44     0.44NA   0.44 NA  0.01   0.45   0.45   0.45   0.45  1XXX.00.00.0002000             25.5217 010 99      1.60   1.60   0.04
9213326Cmptr ophth img optic nerve                       A   0.50   0.33     0.33     0.33     0.33     0.03   0.86   0.86   0.86   0.86  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92134  Cptr ophth dx img post segmt                      A   0.50   0.77     0.77     0.77NA   0.77 NA  0.04   1.31   1.31   1.31   1.31  1XXX.00.00.0002000             25.5217 090 99      1.93   1.93   0.07
92134TCCptr ophth dx img post segmt                      A   0.00   0.44     0.44     0.44NA   0.44 NA  0.01   0.45   0.45   0.45   0.45  1XXX.00.00.0002000             25.5217 010 99      1.60   1.60   0.04
9213426Cptr ophth dx img post segmt                      A   0.50   0.33     0.33     0.33     0.33     0.03   0.86   0.86   0.86   0.86  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92136  Ophthalmic biometry                               A   0.54   1.88     1.95     1.88NA   1.95 NA  0.02   2.44   2.51   2.44   2.51  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92136TCOphthalmic biometry                               A   0.00   1.56     1.57     1.56NA   1.57 NA  0.01   1.57   1.58   1.57   1.58  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
9213626Ophthalmic biometry                               A   0.54   0.32     0.38     0.32     0.38     0.01   0.87   0.93   0.87   0.93  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
92140  Glaucoma provocative tests                        A   0.50   1.20     1.26     0.24     0.28     0.03   1.73   1.79   0.77   0.81  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92225  Special eye exam initial                          A   0.38   0.34     0.39     0.21     0.24     0.03   0.75   0.80   0.62   0.65  0XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
92226  Special eye exam subsequent                       A   0.33   0.33     0.38     0.19     0.23     0.01   0.67   0.72   0.53   0.57  0XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
92227  Remote dx retinal imaging                         A   0.00   0.33     0.33     0.33NA   0.33 NA  0.01   0.34   0.34   0.34   0.34  9XXX.00.00.0002000             25.5217 090 99      0.70   0.70   0.02
92228  Remote retinal imaging mgmt                       A   0.30   0.56     0.56     0.56NA   0.56 NA  0.02   0.88   0.88   0.88   0.88  1XXX.00.00.0002000             25.5217 090 99      0.90   0.90   0.03
92228TCRemote retinal imaging mgmt                       A   0.00   0.36     0.36     0.36NA   0.36 NA  0.01   0.37   0.37   0.37   0.37  1XXX.00.00.0002000             25.5217 010 99      0.70   0.70   0.02
9222826Remote retinal imaging mgmt                       A   0.30   0.20     0.20     0.20     0.20     0.01   0.51   0.51   0.51   0.51  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92230  Eye exam with photos                              A   0.60   1.06     1.01     0.31     0.36     0.04   1.70   1.65   0.95   1.00  0XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
92235  Eye exam with photos                              A   0.81   3.00     3.10     3.00NA   3.10 NA  0.04   3.85   3.95   3.85   3.95  1XXX.00.00.0003000             25.5217 090 99      6.69   6.69   0.05
92235TCEye exam with photos                              A   0.00   2.51     2.53     2.51NA   2.53 NA  0.01   2.52   2.54   2.52   2.54  1XXX.00.00.0003000             25.5217 020 99      6.20   6.20   0.02
9223526Eye exam with photos                              A   0.81   0.49     0.57     0.49     0.57     0.03   1.33   1.41   1.33   1.41  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
92240  Icg angiography                                   A   1.10   5.90     5.87     5.90NA   5.87 NA  0.04   7.04   7.01   7.04   7.01  1XXX.00.00.0003000             25.5217 090 99      6.89   6.89   0.04
92240TCIcg angiography                                   A   0.00   5.23     5.10     5.23NA   5.10 NA  0.01   5.24   5.11   5.24   5.11  1XXX.00.00.0003000             25.5217 020 99      6.22   6.22   0.01
9224026Icg angiography                                   A   1.10   0.67     0.77     0.67     0.77     0.03   1.80   1.90   1.80   1.90  1XXX.00.00.0003000             25.5217 090 99      0.00   0.00   0.00
92250  Eye exam with photos                              A   0.44   1.70     1.74     1.70NA   1.74 NA  0.02   2.16   2.20   2.16   2.20  1XXX.00.00.0002000             25.5217 090 99      2.83   2.83   0.03
92250TCEye exam with photos                              A   0.00   1.47     1.48     1.47NA   1.48 NA  0.01   1.48   1.49   1.48   1.49  1XXX.00.00.0002000             25.5217 010 99      2.60   2.60   0.02
9225026Eye exam with photos                              A   0.44   0.23     0.26     0.23     0.26     0.01   0.68   0.71   0.68   0.71  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92260  Ophthalmoscopy/dynamometry                        A   0.20   0.32     0.33     0.11     0.13     0.01   0.53   0.54   0.32   0.34  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92265  Eye muscle evaluation                             A   0.81   1.48     1.60     1.48NA   1.60 NA  0.02   2.31   2.43   2.31   2.43  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92265TCEye muscle evaluation                             A   0.00   1.04     1.03     1.04NA   1.03 NA  0.01   1.05   1.04   1.05   1.04  1XXX.00.00.0002000             25.5217 030 99      0.00   0.00   0.00
9226526Eye muscle evaluation                             A   0.81   0.44     0.57     0.44     0.57     0.01   1.26   1.39   1.26   1.39  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92270  Electro-oculography                               A   0.81   1.73     1.73     1.73NA   1.73 NA  0.04   2.58   2.58   2.58   2.58  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
92270TCElectro-oculography                               A   0.00   1.37     1.34     1.37NA   1.34 NA  0.01   1.38   1.35   1.38   1.35  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9227026Electro-oculography                               A   0.81   0.36     0.39     0.36     0.39     0.03   1.20   1.23   1.20   1.23  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92275  Electroretinography                               A   1.01   3.13     3.40     3.13NA   3.40 NA  0.05   4.19   4.46   4.19   4.46  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
92275TCElectroretinography                               A   0.00   2.53     2.70     2.53NA   2.70 NA  0.01   2.54   2.71   2.54   2.71  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9227526Electroretinography                               A   1.01   0.60     0.70     0.60     0.70     0.04   1.65   1.75   1.65   1.75  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92283  Color vision examination                          A   0.17   1.25     1.32     1.25NA   1.32 NA  0.02   1.44   1.51   1.44   1.51  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92283TCColor vision examination                          A   0.00   1.17     1.23     1.17NA   1.23 NA  0.01   1.18   1.24   1.18   1.24  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9228326Color vision examination                          A   0.17   0.08     0.09     0.08     0.09     0.01   0.26   0.27   0.26   0.27  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92284  Dark adaptation eye exam                          A   0.24   1.49     1.40     1.49NA   1.40 NA  0.02   1.75   1.66   1.75   1.66  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92284TCDark adaptation eye exam                          A   0.00   1.39     1.29     1.39NA   1.29 NA  0.01   1.40   1.30   1.40   1.30  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9228426Dark adaptation eye exam                          A   0.24   0.10     0.11     0.10     0.11     0.01   0.35   0.36   0.35   0.36  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92285  Eye photography                                   A   0.05   0.75     0.49     0.75NA   0.49 NA  0.02   0.82   0.56   0.82   0.56  1XXX.00.00.0002000             25.5217 010 99      2.64   2.64   0.05
92285TCEye photography                                   A   0.00   0.69     0.46     0.69NA   0.46 NA  0.01   0.70   0.47   0.70   0.47  1XXX.00.00.0002000             25.5217 010 99      2.58   2.58   0.04
9228526Eye photography                                   A   0.05   0.06     0.03     0.06     0.03     0.01   0.12   0.09   0.12   0.09  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92286  Internal eye photography                          A   0.66   2.82     2.81     2.82NA   2.81 NA  0.02   3.50   3.49   3.50   3.49  1XXX.00.00.0002000             25.5217 010 99      6.56   6.56   0.04
92286TCInternal eye photography                          A   0.00   2.46     2.39     2.46NA   2.39 NA  0.01   2.47   2.40   2.47   2.40  1XXX.00.00.0002000             25.5217 010 99      6.20   6.20   0.03
9228626Internal eye photography                          A   0.66   0.36     0.42     0.36     0.42     0.01   1.03   1.09   1.03   1.09  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92287  Internal eye photography                          A   0.81   2.58     2.67     0.47     0.57     0.04   3.43   3.52   1.32   1.42  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92310  Contact lens fitting                              N+  1.17   1.51     1.50     0.51     0.51     0.08   2.76   2.75   1.76   1.76  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92311  Contact lens fitting                              A   1.08   1.68     1.82     0.49     0.56     0.08   2.84   2.98   1.65   1.72  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92312  Contact lens fitting                              A   1.26   1.91     2.11     0.57     0.64     0.05   3.22   3.42   1.88   1.95  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92313  Contact lens fitting                              A   0.92   1.82     2.00     0.49     0.58     0.05   2.79   2.97   1.46   1.55  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92314  Prescription of contact lens                      N+  0.69   1.50     1.52     0.30     0.30     0.04   2.23   2.25   1.03   1.03  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92315  Prescription of contact lens                      A   0.45   1.58     1.70     0.20     0.22     0.04   2.07   2.19   0.69   0.71  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92316  Prescription of contact lens                      A   0.68   2.05     2.32     0.39     0.48     0.04   2.77   3.04   1.11   1.20  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92317  Prescription of contact lens                      A   0.45   1.60     1.68     0.17     0.18     0.01   2.06   2.14   0.63   0.64  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92325  Modification of contact lens                      A   0.00   0.98     1.07     0.98NA   1.07 NA  0.01   0.99   1.08   0.99   1.08  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92326  Replacement of contact lens                       A   0.00   1.04     0.93     1.04NA   0.93 NA  0.01   1.05   0.94   1.05   0.94  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92340  Fitting of spectacles                             N+  0.37   0.65     0.61     0.16     0.16     0.03   1.05   1.01   0.56   0.56  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92341  Fitting of spectacles                             N+  0.47   0.69     0.65     0.20     0.21     0.03   1.19   1.15   0.70   0.71  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92342  Fitting of spectacles                             N+  0.53   0.72     0.68     0.23     0.23     0.04   1.29   1.25   0.80   0.80  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92352  Special spectacles fitting                        B+  0.37   0.78     0.76     0.16     0.16     0.03   1.18   1.16   0.56   0.56  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92353  Special spectacles fitting                        B+  0.50   0.84     0.81     0.21     0.22     0.03   1.37   1.34   0.74   0.75  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92354  Special spectacles fitting                        B+  0.00   1.67     0.36     1.67NA   0.36 NA  0.01   1.68   0.37   1.68   0.37  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92355  Special spectacles fitting                        B+  0.00   1.16     0.56     1.16NA   0.56 NA  0.01   1.17   0.57   1.17   0.57  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92358  Eye prosthesis service                            B+  0.00   0.42     0.30     0.42NA   0.30 NA  0.01   0.43   0.31   0.43   0.31  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92370  Repair & adjust spectacles                        N+  0.32   0.56     0.54     0.14     0.14     0.03   0.91   0.89   0.49   0.49  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92371  Repair & adjust spectacles                        B+  0.00   0.37     0.30     0.37NA   0.30 NA  0.01   0.38   0.31   0.38   0.31  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92499  Eye service or procedure                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92499TCEye service or procedure                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9249926Eye service or procedure                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92502  Ear and throat examination                        A   1.51   1.28NA   1.36NA   1.28     1.36     0.07   2.86   2.94   2.86   2.94  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92504  Ear microscopy examination                        A   0.18   0.70     0.70     0.10     0.11     0.01   0.89   0.89   0.29   0.30  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92506  Speech/hearing evaluation                         A   0.86   2.26     0.66     2.26NA   0.66 NA  0.05   3.17   1.57   3.17   1.57  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
92507  Speech/hearing therapy                            A   1.30   1.05     0.69     1.05NA   0.69 NA  0.07   2.42   2.06   2.42   2.06  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
92508  Speech/hearing therapy                            A   0.33   0.45     0.24     0.45NA   0.24 NA  0.01   0.79   0.58   0.79   0.58  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
92511  Nasopharyngoscopy                                 A   0.84   3.85     3.84     0.90     0.95     0.04   4.73   4.72   1.78   1.83  0XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
92512  Nasal function studies                            A   0.55   1.24     1.22     0.27     0.31     0.03   1.82   1.80   0.85   0.89  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92516  Facial nerve function test                        A   0.43   1.54     1.61     0.23     0.25     0.03   2.00   2.07   0.69   0.71  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92520  Laryngeal function studies                        A   0.75   1.21     1.38     0.42     0.49     0.04   2.00   2.17   1.21   1.28  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92526  Oral function therapy                             A   1.34   1.36     0.78     1.36NA   0.78 NA  0.07   2.77   2.19   2.77   2.19  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
92531  Spontaneous nystagmus study                       B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92532  Positional nystagmus test                         B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92533  Caloric vestibular test                           B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92534  Optokinetic nystagmus test                        B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92540  Basic vestibular evaluation                       A   1.50   1.31     1.31     1.31NA   1.31 NA  0.05   2.86   2.86   2.86   2.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92540TCBasic vestibular evaluation                       A   0.00   0.54     0.54     0.54NA   0.54 NA  0.01   0.55   0.55   0.55   0.55  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9254026Basic vestibular evaluation                       A   1.50   0.77     0.77     0.77     0.77     0.04   2.31   2.31   2.31   2.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92541  Spontaneous nystagmus test                        A   0.40   0.92     0.46     0.92NA   0.46 NA  0.02   1.34   0.88   1.34   0.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92541TCSpontaneous nystagmus test                        A   0.00   0.73     0.25     0.73NA   0.25 NA  0.01   0.74   0.26   0.74   0.26  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9254126Spontaneous nystagmus test                        A   0.40   0.19     0.21     0.19     0.21     0.01   0.60   0.62   0.60   0.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92542  Positional nystagmus test                         A   0.33   0.99     0.42     0.99NA   0.42 NA  0.02   1.34   0.77   1.34   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92542TCPositional nystagmus test                         A   0.00   0.83     0.25     0.83NA   0.25 NA  0.01   0.84   0.26   0.84   0.26  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9254226Positional nystagmus test                         A   0.33   0.16     0.17     0.16     0.17     0.01   0.50   0.51   0.50   0.51  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92543  Caloric vestibular test                           A   0.10   0.54     0.30     0.54NA   0.30 NA  0.02   0.66   0.42   0.66   0.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92543TCCaloric vestibular test                           A   0.00   0.49     0.25     0.49NA   0.25 NA  0.01   0.50   0.26   0.50   0.26  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9254326Caloric vestibular test                           A   0.10   0.05     0.05     0.05     0.05     0.01   0.16   0.16   0.16   0.16  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92544  Optokinetic nystagmus test                        A   0.26   0.81     0.37     0.81NA   0.37 NA  0.02   1.09   0.65   1.09   0.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92544TCOptokinetic nystagmus test                        A   0.00   0.69     0.24     0.69NA   0.24 NA  0.01   0.70   0.25   0.70   0.25  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9254426Optokinetic nystagmus test                        A   0.26   0.12     0.13     0.12     0.13     0.01   0.39   0.40   0.39   0.40  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92545  Oscillating tracking test                         A   0.23   0.77     0.36     0.77NA   0.36 NA  0.02   1.02   0.61   1.02   0.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92545TCOscillating tracking test                         A   0.00   0.66     0.24     0.66NA   0.24 NA  0.01   0.67   0.25   0.67   0.25  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9254526Oscillating tracking test                         A   0.23   0.11     0.12     0.11     0.12     0.01   0.35   0.36   0.35   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92546  Sinusoidal rotational test                        A   0.29   2.47     2.60     2.47NA   2.60 NA  0.02   2.78   2.91   2.78   2.91  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92546TCSinusoidal rotational test                        A   0.00   2.34     2.46     2.34NA   2.46 NA  0.01   2.35   2.47   2.35   2.47  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9254626Sinusoidal rotational test                        A   0.29   0.13     0.14     0.13     0.14     0.01   0.43   0.44   0.43   0.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92547  Supplemental electrical test                      A   0.00   0.14     0.15     0.14     0.15     0.01   0.15   0.16   0.15   0.16  3ZZZ.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
92548  Posturography                                     A   0.50   2.50     2.66     2.50NA   2.66 NA  0.02   3.02   3.18   3.02   3.18  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92548TCPosturography                                     A   0.00   2.26     2.40     2.26NA   2.40 NA  0.01   2.27   2.41   2.27   2.41  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9254826Posturography                                     A   0.50   0.24     0.26     0.24     0.26     0.01   0.75   0.77   0.75   0.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92550  Tympanometry & reflex thresh                      A   0.35   0.25     0.25     0.25NA   0.25 NA  0.01   0.61   0.61   0.61   0.61  7XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92551  Pure tone hearing test air                        N+  0.00   0.33     0.31     0.33NA   0.31 NA  0.01   0.34   0.32   0.34   0.32  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92552  Pure tone audiometry air                          A   0.00   0.75     0.82     0.75NA   0.82 NA  0.01   0.76   0.83   0.76   0.83  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92553  Audiometry air & bone                             A   0.00   0.94     0.99     0.94NA   0.99 NA  0.01   0.95   1.00   0.95   1.00  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92555  Speech threshold audiometry                       A   0.00   0.54     0.59     0.54NA   0.59 NA  0.01   0.55   0.60   0.55   0.60  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92556  Speech audiometry complete                        A   0.00   0.85     0.93     0.85NA   0.93 NA  0.01   0.86   0.94   0.86   0.94  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92557  Comprehensive hearing test                        A   0.60   0.56     0.47     0.45     0.33     0.03   1.19   1.10   1.08   0.96  7XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92559  Group audiometric testing                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92560  Bekesy audiometry screen                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92561  Bekesy audiometry diagnosis                       A   0.00   0.96     1.04     0.96NA   1.04 NA  0.01   0.97   1.05   0.97   1.05  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92562  Loudness balance test                             A   0.00   0.93     1.13     0.93NA   1.13 NA  0.01   0.94   1.14   0.94   1.14  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92563  Tone decay hearing test                           A   0.00   0.72     0.81     0.72NA   0.81 NA  0.01   0.73   0.82   0.73   0.82  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92564  Sisi hearing test                                 A   0.00   0.65     0.70     0.65NA   0.70 NA  0.01   0.66   0.71   0.66   0.71  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92565  Stenger test pure tone                            A   0.00   0.38     0.37     0.38NA   0.37 NA  0.01   0.39   0.38   0.39   0.38  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92567  Tympanometry                                      A   0.20   0.24     0.20     0.16     0.11     0.01   0.45   0.41   0.37   0.32  7XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92568  Acoustic refl threshold tst                       A   0.29   0.19     0.16     0.18     0.16     0.01   0.49   0.46   0.48   0.46  7XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92570  Acoustic immitance testing                        A   0.55   0.36     0.36     0.30     0.30     0.03   0.94   0.94   0.88   0.88  7XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92571  Filtered speech hearing test                      A   0.00   0.58     0.65     0.58NA   0.65 NA  0.01   0.59   0.66   0.59   0.66  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92572  Staggered spondaic word test                      A   0.00   0.93     1.28     0.93NA   1.28 NA  0.01   0.94   1.29   0.94   1.29  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92575  Sensorineural acuity test                         A   0.00   1.45     1.74     1.45NA   1.74 NA  0.01   1.46   1.75   1.46   1.75  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92576  Synthetic sentence test                           A   0.00   0.78     0.90     0.78NA   0.90 NA  0.01   0.79   0.91   0.79   0.91  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92577  Stenger test speech                               A   0.00   0.47     0.44     0.47NA   0.44 NA  0.01   0.48   0.45   0.48   0.45  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92579  Visual audiometry (vra)                           A   0.70   0.56     0.56     0.43     0.41     0.03   1.29   1.29   1.16   1.14  7XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92582  Conditioning play audiometry                      A   0.00   1.50     1.70     1.50NA   1.70 NA  0.01   1.51   1.71   1.51   1.71  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92583  Select picture audiometry                         A   0.00   1.04     1.06     1.04NA   1.06 NA  0.01   1.05   1.07   1.05   1.07  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92584  Electrocochleography                              A   0.00   1.96     1.89     1.96NA   1.89 NA  0.01   1.97   1.90   1.97   1.90  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92585  Auditor evoke potent compre                       A   0.50   2.82     3.07     2.82NA   3.07 NA  0.02   3.34   3.59   3.34   3.59  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92585TCAuditor evoke potent compre                       A   0.00   2.58     2.80     2.58NA   2.80 NA  0.01   2.59   2.81   2.59   2.81  1XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
9258526Auditor evoke potent compre                       A   0.50   0.24     0.27     0.24     0.27     0.01   0.75   0.78   0.75   0.78  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92586  Auditor evoke potent limit                        A   0.00   2.07     2.21     2.07NA   2.21 NA  0.01   2.08   2.22   2.08   2.22  3XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92587  Evoked auditory test                              A   0.13   0.94     0.87     0.94NA   0.87 NA  0.02   1.09   1.02   1.09   1.02  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92587TCEvoked auditory test                              A   0.00   0.87     0.80     0.87NA   0.80 NA  0.01   0.88   0.81   0.88   0.81  1XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
9258726Evoked auditory test                              A   0.13   0.07     0.07     0.07     0.07     0.01   0.21   0.21   0.21   0.21  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92588  Evoked auditory test                              A   0.36   1.57     1.62     1.57NA   1.62 NA  0.02   1.95   2.00   1.95   2.00  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92588TCEvoked auditory test                              A   0.00   1.39     1.42     1.39NA   1.42 NA  0.01   1.40   1.43   1.40   1.43  1XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
9258826Evoked auditory test                              A   0.36   0.18     0.20     0.18     0.20     0.01   0.55   0.57   0.55   0.57  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92590  Hearing aid exam one ear                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92591  Hearing aid exam both ears                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92592  Hearing aid check one ear                         N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92593  Hearing aid check both ears                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92594  Electro hearng aid test one                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92595  Electro hearng aid tst both                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92596  Ear protector evaluation                          A   0.00   1.16     1.23     1.16NA   1.23 NA  0.01   1.17   1.24   1.17   1.24  3XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
92597  Oral speech device eval                           A   1.26   1.55     0.81     1.55NA   0.81 NA  0.07   2.88   2.14   2.88   2.14  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
92601  Cochlear implt f/up exam < 7                      A   2.30   1.89     1.52     1.41     1.01     0.11   4.30   3.93   3.82   3.42  7XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
92602  Reprogram cochlear implt < 7                      A   1.30   1.29     1.02     0.86     0.57     0.07   2.66   2.39   2.23   1.94  7XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
92603  Cochlear implt f/up exam 7 >                      A   2.25   1.84     1.87     1.31     1.22     0.11   4.20   4.23   3.67   3.58  7XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
92604  Reprogram cochlear implt 7 >                      A   1.25   1.19     1.22     0.75     0.68     0.05   2.49   2.52   2.05   1.98  7XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
92605  Eval for nonspeech device rx                      B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92606  Non-speech device service                         B+  1.40   0.93     0.93     0.62     0.62     0.01   2.34   2.34   2.03   2.03  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92607  Ex for speech device rx 1hr                       A   1.85   3.25     1.50     3.25NA   1.50 NA  0.01   5.11   3.36   5.11   3.36  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
92608  Ex for speech device rx addl                      A   0.70   0.80     0.67     0.80NA   0.67 NA  0.01   1.51   1.38   1.51   1.38  7ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92609  Use of speech device service                      A   1.50   1.84     1.04     1.84NA   1.04 NA  0.01   3.35   2.55   3.35   2.55  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
92610  Evaluate swallowing function                      A   1.30   1.73     0.93     0.67     0.67     0.07   3.10   2.30   2.04   2.04  7XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92611  Motion fluoroscopy/swallow                        A   1.34   1.93     1.10     1.93NA   1.10 NA  0.08   3.35   2.52   3.35   2.52  7XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92612  Endoscopy swallow tst (fees)                      A   1.27   3.59     3.62     0.67     0.72     0.07   4.93   4.96   2.01   2.06  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92613  Endoscopy swallow tst (fees)                      A   0.71   0.38     0.40     0.38     0.39     0.04   1.13   1.15   1.13   1.14  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92614  Laryngoscopic sensory test                        A   1.27   3.05     3.10     0.68     0.74     0.07   4.39   4.44   2.02   2.08  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92615  Eval laryngoscopy sense tst                       A   0.63   0.35     0.37     0.35     0.37     0.03   1.01   1.03   1.01   1.03  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92616  Fees w/laryngeal sense test                       A   1.88   3.96     3.98     0.97     1.05     0.10   5.94   5.96   2.95   3.03  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92617  Interprt fees/laryngeal test                      A   0.79   0.41     0.44     0.41     0.44     0.04   1.24   1.27   1.24   1.27  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92620  Auditory function 60 min                          A   1.50   0.86     1.17     0.71     0.88     0.07   2.43   2.74   2.28   2.45  9XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92621  Auditory function + 15 min                        A   0.35   0.20     0.28     0.15     0.18     0.01   0.56   0.64   0.51   0.54  9ZZZ.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
92625  Tinnitus assessment                               A   1.15   0.66     0.84     0.55     0.62     0.05   1.86   2.04   1.75   1.82  9XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92626  Eval aud rehab status                             A   1.40   1.01     1.12     0.82     0.74     0.07   2.48   2.59   2.29   2.21  9XXX.00.00.0002000             25.5217 020 99      0.00   0.00   0.00
92627  Eval aud status rehab add-on                      A   0.33   0.26     0.29     0.20     0.17     0.01   0.60   0.63   0.54   0.51  9ZZZ.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
92630  Aud rehab pre-ling hear loss                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92633  Aud rehab postling hear loss                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92640  Aud brainstem implt programg                      A   1.76   0.78     1.23     0.62     0.91     0.37   2.91   3.36   2.75   3.04  9XXX.00.00.0002000             25.5217 050 99      0.00   0.00   0.00
92700  Ent procedure/service                             C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92950  Heart/lung resuscitation cpr                      A   3.79   4.20     4.20     1.05     1.07     0.30   8.29   8.29   5.14   5.16  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92953  Temporary external pacing                         A   0.23   0.09NA   0.07NA   0.09     0.07     0.01   0.33   0.31   0.33   0.31  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92960  Cardioversion electric ext                        A   2.25   4.72     3.64     1.41     1.13     0.14   7.11   6.03   3.80   3.52  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92961  Cardioversion electric int                        A   4.59   2.48NA   2.04NA   2.48     2.04     0.43   7.50   7.06   7.50   7.06  0000.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
92970  Cardioassist internal                             A   3.51   1.52NA   1.36NA   1.52     1.36     0.24   5.27   5.11   5.27   5.11  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92971  Cardioassist external                             A   1.77   1.05NA   0.83NA   1.05     0.83     0.11   2.93   2.71   2.93   2.71  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92973  Percut coronary thrombectomy                      A   3.28   1.65NA   1.28NA   1.65     1.28     0.71   5.64   5.27   5.64   5.27  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92974  Cath place cardio brachytx                        A   3.00   1.51NA   1.17NA   1.51     1.17     0.65   5.16   4.82   5.16   4.82  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92975  Dissolve clot heart vessel                        A   7.24   3.64NA   2.89NA   3.64     2.89     1.58  12.46  11.71  12.46  11.71  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
92977  Dissolve clot heart vessel                        A   0.00   2.70     1.44     2.70NA   1.44 NA  0.03   2.73   1.47   2.73   1.47  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92978  Intravasc us heart add-on                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92978TCIntravasc us heart add-on                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9297826Intravasc us heart add-on                         A   1.80   0.90     0.70     0.90     0.70     0.12   2.82   2.62   2.82   2.62  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92979  Intravasc us heart add-on                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92979TCIntravasc us heart add-on                         C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9297926Intravasc us heart add-on                         A   1.44   0.73     0.56     0.73     0.56     0.10   2.27   2.10   2.27   2.10  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92980  Insert intracoronary stent                        A  14.82   7.67NA   5.99NA   7.67     5.99     3.23  25.72  24.04  25.72  24.04  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
92981  Insert intracoronary stent                        A   4.16   2.09NA   1.63NA   2.09     1.63     0.90   7.15   6.69   7.15   6.69  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92982  Coronary artery dilation                          A  10.96   5.72NA   4.47NA   5.72     4.47     2.38  19.06  17.81  19.06  17.81  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
92984  Coronary artery dilation                          A   2.97   1.49NA   1.16NA   1.49     1.16     0.64   5.10   4.77   5.10   4.77  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92986  Revision of aortic valve                          A  22.85  14.64NA  11.73NA  14.64    11.73     4.97  42.46  39.55  42.46  39.55  0090.09.84.0720000             25.5217 090 99      0.00   0.00   0.00
92987  Revision of mitral valve                          A  23.63  15.06NA  11.96NA  15.06    11.96     5.13  43.82  40.72  43.82  40.72  0090.09.84.0720000             25.5217 090 99      0.00   0.00   0.00
92990  Revision of pulmonary valve                       A  18.27  11.85NA   9.76NA  11.85     9.76     3.98  34.10  32.01  34.10  32.01  0090.09.84.0720000             25.5217 090 99      0.00   0.00   0.00
92992  Revision of heart chamber                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
92993  Revision of heart chamber                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0090.09.84.0720200             25.5217 090 99      0.00   0.00   0.00
92995  Coronary atherectomy                              A  12.07   6.30NA   4.91NA   6.30     4.91     2.62  20.99  19.60  20.99  19.60  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
92996  Coronary atherectomy add-on                       A   3.26   1.64NA   1.28NA   1.64     1.28     0.71   5.61   5.25   5.61   5.25  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
92997  Pul art balloon repr percut                       A  11.98   5.63NA   4.83NA   5.63     4.83     2.61  20.22  19.42  20.22  19.42  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
92998  Pul art balloon repr percut                       A   5.99   2.87NA   2.33NA   2.87     2.33     1.30  10.16   9.62  10.16   9.62  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93000  Electrocardiogram complete                        A   0.17   0.40     0.32     0.40NA   0.32 NA  0.02   0.59   0.51   0.59   0.51  4XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93005  Electrocardiogram tracing                         A   0.00   0.32     0.25     0.32NA   0.25 NA  0.01   0.33   0.26   0.33   0.26  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93010  Electrocardiogram report                          A   0.17   0.08     0.07     0.08     0.07     0.01   0.26   0.25   0.26   0.25  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93015  Cardiovascular stress test                        A   0.75   1.95     1.59     1.95NA   1.59 NA  0.03   2.73   2.37   2.73   2.37  4XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
93016  Cardiovascular stress test                        A   0.45   0.22     0.18     0.22     0.18     0.01   0.68   0.64   0.68   0.64  2XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
93017  Cardiovascular stress test                        A   0.00   1.58     1.29     1.58NA   1.29 NA  0.01   1.59   1.30   1.59   1.30  3XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
93018  Cardiovascular stress test                        A   0.30   0.15     0.12     0.15     0.12     0.01   0.46   0.43   0.46   0.43  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93024  Cardiac drug stress test                          A   1.17   2.23     1.90     2.23NA   1.90 NA  0.05   3.45   3.12   3.45   3.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93024TCCardiac drug stress test                          A   0.00   1.67     1.44     1.67NA   1.44 NA  0.01   1.68   1.45   1.68   1.45  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9302426Cardiac drug stress test                          A   1.17   0.56     0.46     0.56     0.46     0.04   1.77   1.67   1.77   1.67  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93025  Microvolt t-wave assess                           A   0.75   4.91     3.69     4.91NA   3.69 NA  0.04   5.70   4.48   5.70   4.48  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
93025TCMicrovolt t-wave assess                           A   0.00   4.54     3.39     4.54NA   3.39 NA  0.01   4.55   3.40   4.55   3.40  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9302526Microvolt t-wave assess                           A   0.75   0.37     0.30     0.37     0.30     0.03   1.15   1.08   1.15   1.08  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
93040  Rhythm ECG with report                            A   0.15   0.22     0.19     0.22NA   0.19 NA  0.02   0.39   0.36   0.39   0.36  4XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93041  Rhythm ecg tracing                                A   0.00   0.16     0.14     0.16NA   0.14 NA  0.01   0.17   0.15   0.17   0.15  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93042  Rhythm ecg report                                 A   0.15   0.06     0.05     0.06     0.05     0.01   0.22   0.21   0.22   0.21  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93224  Ecg monit/reprt up to 48 hrs                      A   0.52   2.54     1.97     2.54NA   1.97 NA  0.03   3.09   2.52   3.09   2.52  4XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93225  Ecg monit/reprt up to 48 hrs                      A   0.00   1.01     0.90     1.01NA   0.90 NA  0.01   1.02   0.91   1.02   0.91  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93226  Ecg monit/reprt up to 48 hrs                      A   0.00   1.26     0.83     1.26NA   0.83 NA  0.01   1.27   0.84   1.27   0.84  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93227  Ecg monit/reprt up to 48 hrs                      A   0.52   0.27     0.24     0.27     0.24     0.01   0.80   0.77   0.80   0.77  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93228  Remote 30 day ecg rev/report                      A   0.52   0.21     0.21     0.21     0.21     0.03   0.76   0.76   0.76   0.76  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93229  Remote 30 day ecg tech supp                       A   0.00  20.13    20.13    20.13NA  20.13 NA  0.01  20.14  20.14  20.14  20.14  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93268  ECG record/review                                 A   0.52   6.85     5.69     6.85NA   5.69 NA  0.03   7.40   6.24   7.40   6.24  4XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93270  Remote 30 day ecg rev/report                      A   0.00   0.44     0.24     0.44NA   0.24 NA  0.01   0.45   0.25   0.45   0.25  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93271  Ecg/monitoring and analysis                       A   0.00   6.18     5.25     6.18NA   5.25 NA  0.01   6.19   5.26   6.19   5.26  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93272  Ecg/review interpret only                         A   0.52   0.23     0.20     0.23     0.20     0.01   0.76   0.73   0.76   0.73  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93278  ECG/signal-averaged                               A   0.25   0.77     0.61     0.77NA   0.61 NA  0.02   1.04   0.88   1.04   0.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93278TCECG/signal-averaged                               A   0.00   0.65     0.50     0.65NA   0.50 NA  0.01   0.66   0.51   0.66   0.51  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9327826ECG/signal-averaged                               A   0.25   0.12     0.11     0.12     0.11     0.01   0.38   0.37   0.38   0.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93279  Pm device progr eval sngl                         A   0.65   0.87     0.71     0.87NA   0.71 NA  0.04   1.56   1.40   1.56   1.40  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93279TCPm device progr eval sngl                         A   0.00   0.54     0.45     0.54NA   0.45 NA  0.01   0.55   0.46   0.55   0.46  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9327926Pm device progr eval sngl                         A   0.65   0.33     0.26     0.33     0.26     0.03   1.01   0.94   1.01   0.94  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93280  Pm device progr eval dual                         A   0.77   1.02     0.81     1.02NA   0.81 NA  0.04   1.83   1.62   1.83   1.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93280TCPm device progr eval dual                         A   0.00   0.62     0.51     0.62NA   0.51 NA  0.01   0.63   0.52   0.63   0.52  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328026Pm device progr eval dual                         A   0.77   0.40     0.30     0.40     0.30     0.03   1.20   1.10   1.20   1.10  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93281  Pm device progr eval multi                        A   0.90   1.19     0.94     1.19NA   0.94 NA  0.04   2.13   1.88   2.13   1.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93281TCPm device progr eval multi                        A   0.00   0.72     0.59     0.72NA   0.59 NA  0.01   0.73   0.60   0.73   0.60  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328126Pm device progr eval multi                        A   0.90   0.47     0.35     0.47     0.35     0.03   1.40   1.28   1.40   1.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93282  Icd device prog eval 1 sngl                       A   0.85   1.07     0.85     1.07NA   0.85 NA  0.04   1.96   1.74   1.96   1.74  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93282TCIcd device prog eval 1 sngl                       A   0.00   0.64     0.52     0.64NA   0.52 NA  0.01   0.65   0.53   0.65   0.53  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328226Icd device prog eval 1 sngl                       A   0.85   0.43     0.33     0.43     0.33     0.03   1.31   1.21   1.31   1.21  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93283  Icd device progr eval dual                        A   1.15   1.31     1.05     1.31NA   1.05 NA  0.05   2.51   2.25   2.51   2.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93283TCIcd device progr eval dual                        A   0.00   0.74     0.60     0.74NA   0.60 NA  0.01   0.75   0.61   0.75   0.61  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328326Icd device progr eval dual                        A   1.15   0.57     0.45     0.57     0.45     0.04   1.76   1.64   1.76   1.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93284  Icd device progr eval mult                        A   1.25   1.50     1.18     1.50NA   1.18 NA  0.05   2.80   2.48   2.80   2.48  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93284TCIcd device progr eval mult                        A   0.00   0.85     0.69     0.85NA   0.69 NA  0.01   0.86   0.70   0.86   0.70  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328426Icd device progr eval mult                        A   1.25   0.65     0.49     0.65     0.49     0.04   1.94   1.78   1.94   1.78  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93285  Ilr device eval progr                             A   0.52   0.76     0.61     0.76NA   0.61 NA  0.02   1.30   1.15   1.30   1.15  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93285TCIlr device eval progr                             A   0.00   0.49     0.40     0.49NA   0.40 NA  0.01   0.50   0.41   0.50   0.41  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328526Ilr device eval progr                             A   0.52   0.27     0.21     0.27     0.21     0.01   0.80   0.74   0.80   0.74  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93286  Pre-op pm device eval                             A   0.30   0.46     0.41     0.46NA   0.41 NA  0.02   0.78   0.73   0.78   0.73  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93286TCPre-op pm device eval                             A   0.00   0.34     0.29     0.34NA   0.29 NA  0.01   0.35   0.30   0.35   0.30  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328626Pre-op pm device eval                             A   0.30   0.12     0.12     0.12     0.12     0.01   0.43   0.43   0.43   0.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93287  Pre-op icd device eval                            A   0.45   0.56     0.50     0.56NA   0.50 NA  0.02   1.03   0.97   1.03   0.97  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93287TCPre-op icd device eval                            A   0.00   0.38     0.32     0.38NA   0.32 NA  0.01   0.39   0.33   0.39   0.33  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328726Pre-op icd device eval                            A   0.45   0.18     0.18     0.18     0.18     0.01   0.64   0.64   0.64   0.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93288  Pm device eval in person                          A   0.43   0.73     0.58     0.73NA   0.58 NA  0.02   1.18   1.03   1.18   1.03  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93288TCPm device eval in person                          A   0.00   0.50     0.41     0.50NA   0.41 NA  0.01   0.51   0.42   0.51   0.42  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328826Pm device eval in person                          A   0.43   0.23     0.17     0.23     0.17     0.01   0.67   0.61   0.67   0.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93289  Icd device interrogate                            A   0.92   1.05     0.86     1.05NA   0.86 NA  0.04   2.01   1.82   2.01   1.82  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93289TCIcd device interrogate                            A   0.00   0.62     0.50     0.62NA   0.50 NA  0.01   0.63   0.51   0.63   0.51  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9328926Icd device interrogate                            A   0.92   0.43     0.36     0.43     0.36     0.03   1.38   1.31   1.38   1.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93290  Icm device eval                                   A   0.43   0.45     0.41     0.45NA   0.41 NA  0.02   0.90   0.86   0.90   0.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93290TCIcm device eval                                   A   0.00   0.28     0.24     0.28NA   0.24 NA  0.01   0.29   0.25   0.29   0.25  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9329026Icm device eval                                   A   0.43   0.17     0.17     0.17     0.17     0.01   0.61   0.61   0.61   0.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93291  Ilr device interrogate                            A   0.43   0.69     0.54     0.69NA   0.54 NA  0.02   1.14   0.99   1.14   0.99  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93291TCIlr device interrogate                            A   0.00   0.46     0.37     0.46NA   0.37 NA  0.01   0.47   0.38   0.47   0.38  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9329126Ilr device interrogate                            A   0.43   0.23     0.17     0.23     0.17     0.01   0.67   0.61   0.67   0.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93292  Wcd device interrogate                            A   0.43   0.56     0.45     0.56NA   0.45 NA  0.02   1.01   0.90   1.01   0.90  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93292TCWcd device interrogate                            A   0.00   0.34     0.28     0.34NA   0.28 NA  0.01   0.35   0.29   0.35   0.29  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9329226Wcd device interrogate                            A   0.43   0.22     0.17     0.22     0.17     0.01   0.66   0.61   0.66   0.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93293  Pm phone r-strip device eval                      A   0.32   1.32     1.15     1.32NA   1.15 NA  0.02   1.66   1.49   1.66   1.49  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93293TCPm phone r-strip device eval                      A   0.00   1.18     1.03     1.18NA   1.03 NA  0.01   1.19   1.04   1.19   1.04  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9329326Pm phone r-strip device eval                      A   0.32   0.14     0.12     0.14     0.12     0.01   0.47   0.45   0.47   0.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93294  Pm device interrogate remote                      A   0.65   0.34     0.26     0.34     0.26     0.04   1.03   0.95   1.03   0.95  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93295  Icd device interrogat remote                      A   1.29   0.64     0.51     0.64     0.51     0.08   2.01   1.88   2.01   1.88  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93296  Pm/icd remote tech serv                           A   0.00   0.96     0.70     0.96NA   0.70 NA  0.01   0.97   0.71   0.97   0.71  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93297  Icm device interrogat remote                      A   0.52   0.21     0.20     0.21     0.20     0.03   0.76   0.75   0.76   0.75  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93298  Ilr device interrogat remote                      A   0.52   0.27     0.20     0.27     0.20     0.03   0.82   0.75   0.82   0.75  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93299  Icm/ilr remote tech serv                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93303  Echo transthoracic                                A   1.30   4.86     4.25     4.86NA   4.25 NA  0.05   6.21   5.60   6.21   5.60  1XXX.00.00.0000000             25.5217 090 99     22.58  22.58   0.09
93303TCEcho transthoracic                                A   0.00   4.25     3.72     4.25NA   3.72 NA  0.01   4.26   3.73   4.26   3.73  1XXX.00.00.0000000             25.5217 010 99     21.97  21.97   0.05
9330326Echo transthoracic                                A   1.30   0.61     0.53     0.61     0.53     0.04   1.95   1.87   1.95   1.87  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93304  Echo transthoracic                                A   0.75   3.17     2.87     3.17NA   2.87 NA  0.04   3.96   3.66   3.96   3.66  1XXX.00.00.0000000             25.5217 090 99     16.05  16.05   0.09
93304TCEcho transthoracic                                A   0.00   2.83     2.57     2.83NA   2.57 NA  0.01   2.84   2.58   2.84   2.58  1XXX.00.00.0000000             25.5217 010 99     15.71  15.71   0.06
9330426Echo transthoracic                                A   0.75   0.34     0.30     0.34     0.30     0.03   1.12   1.08   1.12   1.08  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93306  Tte w/doppler complete                            A   1.30   5.53     4.03     5.53NA   4.03 NA  0.05   6.88   5.38   6.88   5.38  1XXX.00.00.0000000             25.5217 090 99     16.39  16.39   0.07
93306TCTte w/doppler complete                            A   0.00   4.87     3.51     4.87NA   3.51 NA  0.01   4.88   3.52   4.88   3.52  1XXX.00.00.0000000             25.5217 010 99     15.73  15.73   0.03
9330626Tte w/doppler complete                            A   1.30   0.66     0.52     0.66     0.52     0.04   2.00   1.86   2.00   1.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93307  Tte w/o doppler complete                          A   0.92   3.41     2.28     3.41NA   2.28 NA  0.04   4.37   3.24   4.37   3.24  1XXX.00.00.0000000             25.5217 090 99     16.16  16.16   0.08
93307TCTte w/o doppler complete                          A   0.00   2.96     1.90     2.96NA   1.90 NA  0.01   2.97   1.91   2.97   1.91  1XXX.00.00.0000000             25.5217 010 99     15.71  15.71   0.05
9330726Tte w/o doppler complete                          A   0.92   0.45     0.38     0.45     0.38     0.03   1.40   1.33   1.40   1.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93308  Tte f-up or lmtd                                  A   0.53   2.56     2.17     2.56NA   2.17 NA  0.02   3.11   2.72   3.11   2.72  1XXX.00.00.0000000             25.5217 090 99      8.54   8.54   0.05
93308TCTte f-up or lmtd                                  A   0.00   2.30     1.96     2.30NA   1.96 NA  0.01   2.31   1.97   2.31   1.97  1XXX.00.00.0000000             25.5217 010 99      8.28   8.28   0.04
9330826Tte f-up or lmtd                                  A   0.53   0.26     0.21     0.26     0.21     0.01   0.80   0.75   0.80   0.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93312  Echo transesophageal                              A   2.20   7.26     6.60     7.26NA   6.60 NA  0.10   9.56   8.90   9.56   8.90  1XXX.00.00.0000000             25.5217 090 99     22.89  22.89   0.17
93312TCEcho transesophageal                              A   0.00   6.29     5.81     6.29NA   5.81 NA  0.03   6.32   5.84   6.32   5.84  1XXX.00.00.0000000             25.5217 030 99     21.92  21.92   0.10
9331226Echo transesophageal                              A   2.20   0.97     0.79     0.97     0.79     0.07   3.24   3.06   3.24   3.06  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93313  Echo transesophageal                              A   0.95   0.20NA   0.23NA   0.20     0.23     0.07   1.22   1.25   1.22   1.25  0XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
93314  Echo transesophageal                              A   1.25   7.10     6.61     7.10NA   6.61 NA  0.07   8.42   7.93   8.42   7.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93314TCEcho transesophageal                              A   0.00   6.54     6.14     6.54NA   6.14 NA  0.03   6.57   6.17   6.57   6.17  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9331426Echo transesophageal                              A   1.25   0.56     0.47     0.56     0.47     0.04   1.85   1.76   1.85   1.76  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93315  Echo transesophageal                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     23.31  23.31   0.24
93315TCEcho transesophageal                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99     22.02  22.02   0.01
9331526Echo transesophageal                              A   2.78   1.29     1.05     1.29     1.05     0.23   4.30   4.06   4.30   4.06  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93316  Echo transesophageal                              A   0.95   0.30NA   0.28NA   0.30     0.28     0.07   1.32   1.30   1.32   1.30  0XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
93317  Echo transesophageal                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93317TCEcho transesophageal                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9331726Echo transesophageal                              A   1.83   0.73     0.67     0.73     0.67     0.23   2.79   2.73   2.79   2.73  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93318  Echo transesophageal intraop                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     22.89  22.89   0.32
93318TCEcho transesophageal intraop                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99     22.02  22.02   0.01
9331826Echo transesophageal intraop                      A   2.20   0.87     0.77     0.87     0.77     0.31   3.38   3.28   3.38   3.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93320  Doppler echo exam heart                           A   0.38   1.45     0.88     1.45NA   0.88 NA  0.02   1.85   1.28   1.85   1.28  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93320TCDoppler echo exam heart                           A   0.00   1.27     0.73     1.27NA   0.73 NA  0.01   1.28   0.74   1.28   0.74  1ZZZ.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9332026Doppler echo exam heart                           A   0.38   0.18     0.15     0.18     0.15     0.01   0.57   0.54   0.57   0.54  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93321  Doppler echo exam heart                           A   0.15   0.70     0.51     0.70NA   0.51 NA  0.02   0.87   0.68   0.87   0.68  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93321TCDoppler echo exam heart                           A   0.00   0.63     0.45     0.63NA   0.45 NA  0.01   0.64   0.46   0.64   0.46  1ZZZ.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9332126Doppler echo exam heart                           A   0.15   0.07     0.06     0.07     0.06     0.01   0.23   0.22   0.23   0.22  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93325  Doppler color flow add-on                         A   0.07   0.97     0.47     0.97NA   0.47 NA  0.02   1.06   0.56   1.06   0.56  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93325TCDoppler color flow add-on                         A   0.00   0.94     0.44     0.94NA   0.44 NA  0.01   0.95   0.45   0.95   0.45  1ZZZ.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9332526Doppler color flow add-on                         A   0.07   0.03     0.03     0.03     0.03     0.01   0.11   0.11   0.11   0.11  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93350  Stress tte only                                   A   1.46   4.69     4.20     4.69NA   4.20 NA  0.06   6.21   5.72   6.21   5.72  1XXX.00.00.0000000             25.5217 090 99     16.46  16.46   0.09
93350TCStress tte only                                   A   0.00   3.96     3.62     3.96NA   3.62 NA  0.01   3.97   3.63   3.97   3.63  1XXX.00.00.0000000             25.5217 020 99     15.73  15.73   0.04
9335026Stress tte only                                   A   1.46   0.73     0.58     0.73     0.58     0.05   2.24   2.09   2.24   2.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93351  Stress tte complete                               A   1.75   5.49     4.76     5.49NA   4.76 NA  0.08   7.32   6.59   7.32   6.59  1XXX.00.00.0000999             25.5217 090 99     22.79  22.79   0.19
93351TCStress tte complete                               A   0.00   4.58     4.07     4.58NA   4.07 NA  0.03   4.61   4.10   4.61   4.10  1XXX.00.00.0000999             25.5217 020 99     21.88  21.88   0.14
9335126Stress tte complete                               A   1.75   0.91     0.69     0.91     0.69     0.05   2.71   2.49   2.71   2.49  1XXX.00.00.0000999             25.5217 090 99      0.00   0.00   0.00
93352  Admin ecg contrast agent                          A   0.19   0.87     0.72     0.87NA   0.72 NA  0.01   1.07   0.92   1.07   0.92  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93451  Right heart cath                                  A   2.72  19.21    19.21    19.21NA  19.21 NA  0.61  22.54  22.54  22.54  22.54  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93451TCRight heart cath                                  A   0.00  18.14    18.14    18.14NA  18.14 NA  0.03  18.17  18.17  18.17  18.17  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9345126Right heart cath                                  A   2.72   1.07     1.07     1.07     1.07     0.58   4.37   4.37   4.37   4.37  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93452  Left hrt cath w/ventrclgrphy                      A   4.75  19.19    19.19    19.19NA  19.19 NA  1.09  25.03  25.03  25.03  25.03  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93452TCLeft hrt cath w/ventrclgrphy                      A   0.00  17.33    17.33    17.33NA  17.33 NA  0.04  17.37  17.37  17.37  17.37  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9345226Left hrt cath w/ventrclgrphy                      A   4.75   1.86     1.86     1.86     1.86     1.05   7.66   7.66   7.66   7.66  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93453  R&l hrt cath w/ventriclgrphy                      A   6.24  25.10    25.10    25.10NA  25.10 NA  1.42  32.76  32.76  32.76  32.76  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93453TCR&l hrt cath w/ventriclgrphy                      A   0.00  22.66    22.66    22.66NA  22.66 NA  0.05  22.71  22.71  22.71  22.71  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9345326R&l hrt cath w/ventriclgrphy                      A   6.24   2.44     2.44     2.44     2.44     1.37  10.05  10.05  10.05  10.05  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93454  Coronary artery angio s&i                         A   4.79  19.94    19.94    19.94NA  19.94 NA  1.10  25.83  25.83  25.83  25.83  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93454TCCoronary artery angio s&i                         A   0.00  18.06    18.06    18.06NA  18.06 NA  0.04  18.10  18.10  18.10  18.10  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9345426Coronary artery angio s&i                         A   4.79   1.88     1.88     1.88     1.88     1.06   7.73   7.73   7.73   7.73  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93455  Coronary art/grft angio s&i                       A   5.54  23.33    23.33    23.33NA  23.33 NA  1.25  30.12  30.12  30.12  30.12  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93455TCCoronary art/grft angio s&i                       A   0.00  21.16    21.16    21.16NA  21.16 NA  0.05  21.21  21.21  21.21  21.21  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9345526Coronary art/grft angio s&i                       A   5.54   2.17     2.17     2.17     2.17     1.20   8.91   8.91   8.91   8.91  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93456  R hrt coronary artery angio                       A   6.15  24.78    24.78    24.78NA  24.78 NA  1.39  32.32  32.32  32.32  32.32  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93456TCR hrt coronary artery angio                       A   0.00  22.37    22.37    22.37NA  22.37 NA  0.05  22.42  22.42  22.42  22.42  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9345626R hrt coronary artery angio                       A   6.15   2.41     2.41     2.41     2.41     1.34   9.90   9.90   9.90   9.90  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93457  R hrt art/grft angio                              A   6.89  28.18    28.18    28.18NA  28.18 NA  1.54  36.61  36.61  36.61  36.61  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93457TCR hrt art/grft angio                              A   0.00  25.48    25.48    25.48NA  25.48 NA  0.05  25.53  25.53  25.53  25.53  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9345726R hrt art/grft angio                              A   6.89   2.70     2.70     2.70     2.70     1.49  11.08  11.08  11.08  11.08  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93458  L hrt artery/ventricle angio                      A   5.85  23.97    23.97    23.97NA  23.97 NA  1.33  31.15  31.15  31.15  31.15  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93458TCL hrt artery/ventricle angio                      A   0.00  21.68    21.68    21.68NA  21.68 NA  0.05  21.73  21.73  21.73  21.73  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9345826L hrt artery/ventricle angio                      A   5.85   2.29     2.29     2.29     2.29     1.28   9.42   9.42   9.42   9.42  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93459  L hrt art/grft angio                              A   6.60  26.33    26.33    26.33NA  26.33 NA  1.48  34.41  34.41  34.41  34.41  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93459TCL hrt art/grft angio                              A   0.00  23.75    23.75    23.75NA  23.75 NA  0.05  23.80  23.80  23.80  23.80  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9345926L hrt art/grft angio                              A   6.60   2.58     2.58     2.58     2.58     1.43  10.61  10.61  10.61  10.61  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93460  R&l hrt art/ventricle angio                       A   7.35  27.83    27.83    27.83NA  27.83 NA  1.64  36.82  36.82  36.82  36.82  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93460TCR&l hrt art/ventricle angio                       A   0.00  24.95    24.95    24.95NA  24.95 NA  0.05  25.00  25.00  25.00  25.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9346026R&l hrt art/ventricle angio                       A   7.35   2.88     2.88     2.88     2.88     1.59  11.82  11.82  11.82  11.82  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93461  R&l hrt art/ventricle angio                       A   8.10  32.26    32.26    32.26NA  32.26 NA  1.83  42.19  42.19  42.19  42.19  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93461TCR&l hrt art/ventricle angio                       A   0.00  29.09    29.09    29.09NA  29.09 NA  0.06  29.15  29.15  29.15  29.15  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9346126R&l hrt art/ventricle angio                       A   8.10   3.17     3.17     3.17     3.17     1.77  13.04  13.04  13.04  13.04  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93462  L hrt cath trnsptl puncture                       A   3.73   1.48     1.48     1.48     1.48     0.80   6.01   6.01   6.01   6.01  0ZZZ.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93463  Drug admin & hemodynmic meas                      A   2.00   0.79     0.79     0.79     0.79     0.39   3.18   3.18   3.18   3.18  0ZZZ.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93464  Exercise w/hemodynamic meas                       A   1.80   5.28     5.28     5.28NA   5.28 NA  0.36   7.44   7.44   7.44   7.44  1ZZZ.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93464TCExercise w/hemodynamic meas                       A   0.00   4.63     4.63     4.63NA   4.63 NA  0.01   4.64   4.64   4.64   4.64  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9346426Exercise w/hemodynamic meas                       A   1.80   0.65     0.65     0.65     0.65     0.35   2.80   2.80   2.80   2.80  1ZZZ.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93503  Insert/place heart catheter                       A   2.91   0.77NA   0.77NA   0.77     0.77     0.27   3.95   3.95   3.95   3.95  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93505  Biopsy of heart lining                            A   4.37  18.46    17.43    18.46NA  17.43 NA  0.86  23.69  22.66  23.69  22.66  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93505TCBiopsy of heart lining                            A   0.00  16.29    15.71    16.29NA  15.71 NA  0.03  16.32  15.74  16.32  15.74  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9350526Biopsy of heart lining                            A   4.37   2.17     1.72     2.17     1.72     0.83   7.37   6.92   7.37   6.92  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93530  Rt heart cath congenital                          C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93530TCRt heart cath congenital                          C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9353026Rt heart cath congenital                          A   4.22   2.06     1.68     2.06     1.68     0.91   7.19   6.81   7.19   6.81  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93531  R & l heart cath congenital                       C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93531TCR & l heart cath congenital                       C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9353126R & l heart cath congenital                       A   8.34   3.98     3.30     3.98     3.30     1.82  14.14  13.46  14.14  13.46  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93532  R & l heart cath congenital                       C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93532TCR & l heart cath congenital                       C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9353226R & l heart cath congenital                       A   9.99   4.64     3.89     4.64     3.89     2.17  16.80  16.05  16.80  16.05  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93533  R & l heart cath congenital                       C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93533TCR & l heart cath congenital                       C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9353326R & l heart cath congenital                       A   6.69   3.13     2.60     3.13     2.60     1.47  11.29  10.76  11.29  10.76  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93561  Cardiac output measurement                        C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93561TCCardiac output measurement                        C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9356126Cardiac output measurement                        A   0.50   0.19     0.20     0.19     0.20     0.04   0.73   0.74   0.73   0.74  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93562  Cardiac output measurement                        C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93562TCCardiac output measurement                        C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9356226Cardiac output measurement                        A   0.16   0.05     0.06     0.05     0.06     0.01   0.22   0.23   0.22   0.23  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93563  Inject congenital card cath                       A   1.11   0.44     0.44     0.44     0.44     0.10   1.65   1.65   1.65   1.65  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93564  Inject hrt congntl art/grft                       A   1.13   0.45     0.45     0.45     0.45     0.10   1.68   1.68   1.68   1.68  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93565  Inject l ventr/atrial angio                       A   0.86   0.34     0.34     0.34     0.34     0.08   1.28   1.28   1.28   1.28  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93566  Inject r ventr/atrial angio                       A   0.86   4.06     4.06     0.34     0.34     0.07   4.99   4.99   1.27   1.27  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93567  Inject suprvlv aortography                        A   0.97   3.08     3.08     0.38     0.38     0.08   4.13   4.13   1.43   1.43  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93568  Inject pulm art hrt cath                          A   0.88   3.56     3.56     0.35     0.35     0.08   4.52   4.52   1.31   1.31  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93571  Heart flow reserve measure                        C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93571TCHeart flow reserve measure                        C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9357126Heart flow reserve measure                        A   1.80   0.90     0.71     0.90     0.71     0.11   2.81   2.62   2.81   2.62  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93572  Heart flow reserve measure                        C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93572TCHeart flow reserve measure                        C   0.00   0.00NA   0.00NA   0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9357226Heart flow reserve measure                        A   1.44   0.70     0.56     0.70     0.56     0.11   2.25   2.11   2.25   2.11  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93580  Transcath closure of asd                          A  17.97   9.22NA   7.41NA   9.22     7.41     3.91  31.10  29.29  31.10  29.29  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93581  Transcath closure of vsd                          A  24.39  11.58NA   9.83NA  11.58     9.83     5.31  41.28  39.53  41.28  39.53  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93600  Bundle of His recording                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93600TCBundle of His recording                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9360026Bundle of His recording                           A   2.12   1.05     0.84     1.05     0.84     0.45   3.62   3.41   3.62   3.41  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93602  Intra-atrial recording                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93602TCIntra-atrial recording                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9360226Intra-atrial recording                            A   2.12   1.03     0.83     1.03     0.83     0.45   3.60   3.40   3.60   3.40  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93603  Right ventricular recording                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93603TCRight ventricular recording                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9360326Right ventricular recording                       A   2.12   1.03     0.82     1.03     0.82     0.45   3.60   3.39   3.60   3.39  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93609  Map tachycardia add-on                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93609TCMap tachycardia add-on                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9360926Map tachycardia add-on                            A   4.99   2.48     1.96     2.48     1.96     1.09   8.56   8.04   8.56   8.04  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93610  Intra-atrial pacing                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93610TCIntra-atrial pacing                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9361026Intra-atrial pacing                               A   3.02   1.46     1.17     1.46     1.17     0.65   5.13   4.84   5.13   4.84  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93612  Intraventricular pacing                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93612TCIntraventricular pacing                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9361226Intraventricular pacing                           A   3.02   1.44     1.16     1.44     1.16     0.65   5.11   4.83   5.11   4.83  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93613  Electrophys map 3d add-on                         A   6.99   3.50NA   2.74NA   3.50     2.74     1.52  12.01  11.25  12.01  11.25  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93615  Esophageal recording                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93615TCEsophageal recording                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9361526Esophageal recording                              A   0.99   0.48     0.39     0.48     0.39     0.05   1.52   1.43   1.52   1.43  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93616  Esophageal recording                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93616TCEsophageal recording                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9361626Esophageal recording                              A   1.49   0.39     0.35     0.39     0.35     0.11   1.99   1.95   1.99   1.95  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93618  Heart rhythm pacing                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93618TCHeart rhythm pacing                               C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9361826Heart rhythm pacing                               A   4.25   2.14     1.66     2.14     1.66     0.91   7.30   6.82   7.30   6.82  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93619  Electrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93619TCElectrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9361926Electrophysiology evaluation                      A   7.31   3.72     2.86     3.72     2.86     1.59  12.62  11.76  12.62  11.76  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93620  Electrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93620TCElectrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9362026Electrophysiology evaluation                      A  11.57   5.82     4.54     5.82     4.54     2.51  19.90  18.62  19.90  18.62  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93621  Electrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93621TCElectrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9362126Electrophysiology evaluation                      A   2.10   1.05     0.82     1.05     0.82     0.45   3.60   3.37   3.60   3.37  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93622  Electrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93622TCElectrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9362226Electrophysiology evaluation                      A   3.10   1.52     1.22     1.52     1.22     0.67   5.29   4.99   5.29   4.99  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93623  Stimulation pacing heart                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93623TCStimulation pacing heart                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9362326Stimulation pacing heart                          A   2.85   1.42     1.12     1.42     1.12     0.62   4.89   4.59   4.89   4.59  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93624  Electrophysiologic study                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93624TCElectrophysiologic study                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9362426Electrophysiologic study                          A   4.80   2.44     1.87     2.44NA   1.87 NA  1.05   8.29   7.72   8.29   7.72  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93631  Heart pacing mapping                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93631TCHeart pacing mapping                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9363126Heart pacing mapping                              A   7.59   3.08     2.77     3.08     2.77     1.81  12.48  12.17  12.48  12.17  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93640  Evaluation heart device                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93640TCEvaluation heart device                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9364026Evaluation heart device                           A   3.51   1.74     1.39     1.74     1.39     0.76   6.01   5.66   6.01   5.66  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93641  Electrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93641TCElectrophysiology evaluation                      C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9364126Electrophysiology evaluation                      A   5.92   2.95     2.32     2.95     2.32     1.29  10.16   9.53  10.16   9.53  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93642  Electrophysiology evaluation                      A   4.88   7.53     5.71     7.53NA   5.71 NA  0.21  12.62  10.80  12.62  10.80  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93642TCElectrophysiology evaluation                      A   0.00   5.04     3.79     5.04NA   3.79 NA  0.03   5.07   3.82   5.07   3.82  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9364226Electrophysiology evaluation                      A   4.88   2.49     1.92     2.49     1.92     0.18   7.55   6.98   7.55   6.98  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93650  Ablate heart dysrhythm focus                      A  10.49   5.54NA   4.39NA   5.54     4.39     2.27  18.30  17.15  18.30  17.15  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93651  Ablate heart dysrhythm focus                      A  16.23   8.09NA   6.36NA   8.09     6.36     3.53  27.85  26.12  27.85  26.12  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93652  Ablate heart dysrhythm focus                      A  17.65   8.82NA   6.95NA   8.82     6.95     3.84  30.31  28.44  30.31  28.44  0000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93660  Tilt table evaluation                             A   1.89   2.88     2.37     2.88NA   2.37 NA  0.08   4.85   4.34   4.85   4.34  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93660TCTilt table evaluation                             A   0.00   1.94     1.62     1.94NA   1.62 NA  0.01   1.95   1.63   1.95   1.63  1000.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9366026Tilt table evaluation                             A   1.89   0.94     0.75     0.94     0.75     0.07   2.90   2.71   2.90   2.71  1000.00.00.0020000             25.5217 090 99      0.00   0.00   0.00
93662  Intracardiac ecg (ice)                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93662TCIntracardiac ecg (ice)                            C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9366226Intracardiac ecg (ice)                            A   2.80   1.39     1.09     1.39     1.09     0.20   4.39   4.09   4.39   4.09  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93668  Peripheral vascular rehab                         N+  0.00   0.54     0.51     0.54NA   0.51 NA  0.01   0.55   0.52   0.55   0.52  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
93701  Bioimpedance cv analysis                          A   0.00   0.78     0.65     0.78NA   0.65 NA  0.01   0.79   0.66   0.79   0.66  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93720  Total body plethysmography                        A   0.17   1.25     1.23     1.25NA   1.23 NA  0.02   1.44   1.42   1.44   1.42  4XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93721  Plethysmography tracing                           A   0.00   1.19     1.17     1.19NA   1.17 NA  0.01   1.20   1.18   1.20   1.18  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93722  Plethysmography report                            A   0.17   0.06     0.06     0.06     0.06     0.01   0.24   0.24   0.24   0.24  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93724  Analyze pacemaker system                          A   4.88   3.78     2.67     3.78NA   2.67 NA  0.19   8.85   7.74   8.85   7.74  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93724TCAnalyze pacemaker system                          A   0.00   1.35     0.72     1.35NA   0.72 NA  0.01   1.36   0.73   1.36   0.73  1000.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9372426Analyze pacemaker system                          A   4.88   2.43     1.95     2.43     1.95     0.18   7.49   7.01   7.49   7.01  1000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93740  Temperature gradient studies                      B+  0.16   0.07     0.07     0.07NA   0.07 NA  0.02   0.25   0.25   0.25   0.25  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
93740TCTemperature gradient studies                      B+  0.00   0.04     0.00     0.04NA   0.00 NA  0.01   0.05   0.01   0.05   0.01  1XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
9374026Temperature gradient studies                      B+  0.16   0.07     0.07     0.07     0.07     0.01   0.24   0.24   0.24   0.24  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
93745  Set-up cardiovert-defibrill                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93745TCSet-up cardiovert-defibrill                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9374526Set-up cardiovert-defibrill                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93750  Interrogation vad in person                       A   0.92   0.54     0.54     0.34     0.34     0.05   1.51   1.51   1.31   1.31  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93770  Measure venous pressure                           B+  0.16   0.07     0.07     0.07NA   0.07 NA  0.02   0.25   0.25   0.25   0.25  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
93770TCMeasure venous pressure                           B+  0.00   0.01     0.00     0.01NA   0.00 NA  0.01   0.02   0.01   0.02   0.01  1XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
9377026Measure venous pressure                           B+  0.16   0.07     0.07     0.07     0.07     0.01   0.24   0.24   0.24   0.24  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
93784  Ambulatory BP monitoring                          A   0.38   1.42     1.13     1.42NA   1.13 NA  0.03   1.83   1.54   1.83   1.54  4XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93786  Ambulatory BP recording                           A   0.00   0.91     0.83     0.91NA   0.83 NA  0.01   0.92   0.84   0.92   0.84  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
93788  Ambulatory BP analysis                            A   0.00   0.34     0.14     0.34NA   0.14 NA  0.01   0.35   0.15   0.35   0.15  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93790  Review/report BP recording                        A   0.38   0.17     0.16     0.17     0.16     0.01   0.56   0.55   0.56   0.55  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93797  Cardiac rehab                                     A   0.18   0.34     0.30     0.09     0.08     0.01   0.53   0.49   0.28   0.27  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93798  Cardiac rehab/monitor                             A   0.28   0.47     0.41     0.14     0.12     0.01   0.76   0.70   0.43   0.41  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93799  Cardiovascular procedure                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93799TCCardiovascular procedure                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9379926Cardiovascular procedure                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93875  Extracranial study                                A   0.22   2.88     2.75     2.88NA   2.75 NA  0.02   3.12   2.99   3.12   2.99  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93875TCExtracranial study                                A   0.00   2.79     2.66     2.79NA   2.66 NA  0.01   2.80   2.67   2.80   2.67  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9387526Extracranial study                                A   0.22   0.09     0.09     0.09     0.09     0.01   0.32   0.32   0.32   0.32  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93880  Extracranial study                                A   0.60   6.75     6.26     6.75NA   6.26 NA  0.05   7.40   6.91   7.40   6.91  1XXX.00.00.0002000             25.5217 090 99      6.24   6.24   0.05
93880TCExtracranial study                                A   0.00   6.50     6.03     6.50NA   6.03 NA  0.01   6.51   6.04   6.51   6.04  1XXX.00.00.0002000             25.5217 010 99      5.99   5.99   0.01
9388026Extracranial study                                A   0.60   0.25     0.23     0.25     0.23     0.04   0.89   0.87   0.89   0.87  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93882  Extracranial study                                A   0.40   4.67     4.58     4.67NA   4.58 NA  0.06   5.13   5.04   5.13   5.04  1XXX.00.00.0000000             25.5217 090 99      6.13   6.13   0.06
93882TCExtracranial study                                A   0.00   4.52     4.43     4.52NA   4.43 NA  0.01   4.53   4.44   4.53   4.44  1XXX.00.00.0000000             25.5217 010 99      5.98   5.98   0.01
9388226Extracranial study                                A   0.40   0.15     0.15     0.15     0.15     0.05   0.60   0.60   0.60   0.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93886  Intracranial study                                A   0.94   8.80     9.14     8.80NA   9.14 NA  0.05   9.79  10.13   9.79  10.13  1XXX.00.00.0000000             25.5217 090 99      6.39   6.39   0.05
93886TCIntracranial study                                A   0.00   8.40     8.72     8.40NA   8.72 NA  0.01   8.41   8.73   8.41   8.73  1XXX.00.00.0000000             25.5217 010 99      5.99   5.99   0.01
9388626Intracranial study                                A   0.94   0.40     0.42     0.40     0.42     0.04   1.38   1.40   1.38   1.40  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93888  Intracranial study                                A   0.62   5.56     5.38     5.56NA   5.38 NA  0.05   6.23   6.05   6.23   6.05  1XXX.00.00.0000000             25.5217 090 99      2.69   2.69   0.04
93888TCIntracranial study                                A   0.00   5.30     5.12     5.30NA   5.12 NA  0.01   5.31   5.13   5.31   5.13  1XXX.00.00.0000000             25.5217 010 99      2.43   2.43   0.00
9388826Intracranial study                                A   0.62   0.26     0.26     0.26     0.26     0.04   0.92   0.92   0.92   0.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93890  Tcd vasoreactivity study                          A   1.00   6.95     6.76     6.95NA   6.76 NA  0.05   8.00   7.81   8.00   7.81  1XXX.00.00.0000000             25.5217 090 99      4.18   4.18   0.05
93890TCTcd vasoreactivity study                          A   0.00   6.54     6.34     6.54NA   6.34 NA  0.01   6.55   6.35   6.55   6.35  1XXX.00.00.0000000             25.5217 010 99      3.77   3.77   0.01
9389026Tcd vasoreactivity study                          A   1.00   0.41     0.42     0.41     0.42     0.04   1.45   1.46   1.45   1.46  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93892  Tcd emboli detect w/o inj                         A   1.15   8.24     8.65     8.24NA   8.65 NA  0.06   9.45   9.86   9.45   9.86  1XXX.00.00.0000000             25.5217 090 99      4.26   4.26   0.05
93892TCTcd emboli detect w/o inj                         A   0.00   7.75     8.13     7.75NA   8.13 NA  0.01   7.76   8.14   7.76   8.14  1XXX.00.00.0000000             25.5217 010 99      3.77   3.77   0.00
9389226Tcd emboli detect w/o inj                         A   1.15   0.49     0.52     0.49     0.52     0.05   1.69   1.72   1.69   1.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93893  Tcd emboli detect w/inj                           A   1.15   8.65     9.49     8.65NA   9.49 NA  0.06   9.86  10.70   9.86  10.70  1XXX.00.00.0000000             25.5217 090 99      4.27   4.27   0.05
93893TCTcd emboli detect w/inj                           A   0.00   8.15     8.97     8.15NA   8.97 NA  0.01   8.16   8.98   8.16   8.98  1XXX.00.00.0000000             25.5217 010 99      3.77   3.77   0.00
9389326Tcd emboli detect w/inj                           A   1.15   0.50     0.52     0.50     0.52     0.05   1.70   1.72   1.70   1.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93922  Upr/l xtremity art 2 levels                       A   0.25   2.99     2.39     2.99NA   2.39 NA  0.02   3.26   2.66   3.26   2.66  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93922TCUpr/l xtremity art 2 levels                       A   0.00   2.89     2.29     2.89NA   2.29 NA  0.01   2.90   2.30   2.90   2.30  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9392226Upr/l xtremity art 2 levels                       A   0.25   0.10     0.10     0.10     0.10     0.01   0.36   0.36   0.36   0.36  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93923  Upr/lxtr art stdy 3+ lvls                         A   0.45   4.54     3.65     4.54NA   3.65 NA  0.05   5.04   4.15   5.04   4.15  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93923TCUpr/lxtr art stdy 3+ lvls                         A   0.00   4.36     3.48     4.36NA   3.48 NA  0.01   4.37   3.49   4.37   3.49  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9392326Upr/lxtr art stdy 3+ lvls                         A   0.45   0.18     0.17     0.18     0.17     0.04   0.67   0.66   0.67   0.66  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93924  Lwr xtr vasc stdy bilat                           A   0.50   5.76     4.72     5.76NA   4.72 NA  0.05   6.31   5.27   6.31   5.27  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93924TCLwr xtr vasc stdy bilat                           A   0.00   5.55     4.53     5.55NA   4.53 NA  0.01   5.56   4.54   5.56   4.54  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9392426Lwr xtr vasc stdy bilat                           A   0.50   0.21     0.19     0.21     0.19     0.04   0.75   0.73   0.75   0.73  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93925  Lower extremity study                             A   0.58   8.70     8.12     8.70NA   8.12 NA  0.07   9.35   8.77   9.35   8.77  1XXX.00.00.0002000             25.5217 090 99      6.20   6.20   0.06
93925TCLower extremity study                             A   0.00   8.47     7.90     8.47NA   7.90 NA  0.03   8.50   7.93   8.50   7.93  1XXX.00.00.0002000             25.5217 010 99      5.97   5.97   0.02
9392526Lower extremity study                             A   0.58   0.23     0.22     0.23     0.22     0.04   0.85   0.84   0.85   0.84  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93926  Lower extremity study                             A   0.39   5.63     5.37     5.63NA   5.37 NA  0.06   6.08   5.82   6.08   5.82  1XXX.00.00.0000000             25.5217 090 99      3.92   3.92   0.06
93926TCLower extremity study                             A   0.00   5.48     5.23     5.48NA   5.23 NA  0.01   5.49   5.24   5.49   5.24  1XXX.00.00.0000000             25.5217 010 99      3.77   3.77   0.01
9392626Lower extremity study                             A   0.39   0.15     0.14     0.15     0.14     0.05   0.59   0.58   0.59   0.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93930  Upper extremity study                             A   0.46   6.87     6.49     6.87NA   6.49 NA  0.05   7.38   7.00   7.38   7.00  1XXX.00.00.0002000             25.5217 090 99      6.18   6.18   0.05
93930TCUpper extremity study                             A   0.00   6.68     6.32     6.68NA   6.32 NA  0.01   6.69   6.33   6.69   6.33  1XXX.00.00.0002000             25.5217 010 99      5.99   5.99   0.01
9393026Upper extremity study                             A   0.46   0.19     0.17     0.19     0.17     0.04   0.69   0.67   0.69   0.67  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93931  Upper extremity study                             A   0.31   4.58     4.31     4.58NA   4.31 NA  0.04   4.93   4.66   4.93   4.66  1XXX.00.00.0000000             25.5217 090 99      3.88   3.88   0.04
93931TCUpper extremity study                             A   0.00   4.46     4.20     4.46NA   4.20 NA  0.01   4.47   4.21   4.47   4.21  1XXX.00.00.0000000             25.5217 010 99      3.76   3.76   0.01
9393126Upper extremity study                             A   0.31   0.12     0.11     0.12     0.11     0.03   0.46   0.45   0.46   0.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93965  Extremity study                                   A   0.35   3.35     3.12     3.35NA   3.12 NA  0.04   3.74   3.51   3.74   3.51  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93965TCExtremity study                                   A   0.00   3.21     2.99     3.21NA   2.99 NA  0.01   3.22   3.00   3.22   3.00  1XXX.00.00.0002000             25.5217 010 99      0.00   0.00   0.00
9396526Extremity study                                   A   0.35   0.14     0.13     0.14     0.13     0.03   0.52   0.51   0.52   0.51  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93970  Extremity study                                   A   0.68   6.87     6.49     6.87NA   6.49 NA  0.08   7.63   7.25   7.63   7.25  1XXX.00.00.0002000             25.5217 090 99      6.26   6.26   0.08
93970TCExtremity study                                   A   0.00   6.60     6.24     6.60NA   6.24 NA  0.01   6.61   6.25   6.61   6.25  1XXX.00.00.0002000             25.5217 010 99      5.99   5.99   0.01
9397026Extremity study                                   A   0.68   0.27     0.25     0.27     0.25     0.07   1.02   1.00   1.02   1.00  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
93971  Extremity study                                   A   0.45   4.51     4.23     4.51NA   4.23 NA  0.05   5.01   4.73   5.01   4.73  1XXX.00.00.0000000             25.5217 090 99      3.94   3.94   0.05
93971TCExtremity study                                   A   0.00   4.33     4.06     4.33NA   4.06 NA  0.01   4.34   4.07   4.34   4.07  1XXX.00.00.0000000             25.5217 010 99      3.76   3.76   0.01
9397126Extremity study                                   A   0.45   0.18     0.17     0.18     0.17     0.04   0.67   0.66   0.67   0.66  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93975  Vascular study                                    A   1.80   9.27     8.57     9.27NA   8.57 NA  0.17  11.24  10.54  11.24  10.54  1XXX.00.00.0000000             25.5217 090 99      6.71   6.71   0.16
93975TCVascular study                                    A   0.00   8.53     7.89     8.53NA   7.89 NA  0.03   8.56   7.92   8.56   7.92  1XXX.00.00.0000000             25.5217 010 99      5.97   5.97   0.02
9397526Vascular study                                    A   1.80   0.74     0.68     0.74     0.68     0.14   2.68   2.62   2.68   2.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93976  Vascular study                                    A   1.21   5.12     4.74     5.12NA   4.74 NA  0.09   6.42   6.04   6.42   6.04  1XXX.00.00.0000000             25.5217 090 99      6.48   6.48   0.09
93976TCVascular study                                    A   0.00   4.62     4.28     4.62NA   4.28 NA  0.01   4.63   4.29   4.63   4.29  1XXX.00.00.0000000             25.5217 010 99      5.98   5.98   0.01
9397626Vascular study                                    A   1.21   0.50     0.46     0.50     0.46     0.08   1.79   1.75   1.79   1.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93978  Vascular study                                    A   0.65   6.44     6.08     6.44NA   6.08 NA  0.08   7.17   6.81   7.17   6.81  1XXX.00.00.0000000             25.5217 090 99      6.24   6.24   0.08
93978TCVascular study                                    A   0.00   6.18     5.84     6.18NA   5.84 NA  0.01   6.19   5.85   6.19   5.85  1XXX.00.00.0000000             25.5217 010 99      5.98   5.98   0.01
9397826Vascular study                                    A   0.65   0.26     0.24     0.26     0.24     0.07   0.98   0.96   0.98   0.96  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93979  Vascular study                                    A   0.44   4.48     4.22     4.48NA   4.22 NA  0.05   4.97   4.71   4.97   4.71  1XXX.00.00.0000000             25.5217 090 99      3.93   3.93   0.05
93979TCVascular study                                    A   0.00   4.31     4.06     4.31NA   4.06 NA  0.01   4.32   4.07   4.32   4.07  1XXX.00.00.0000000             25.5217 010 99      3.76   3.76   0.01
9397926Vascular study                                    A   0.44   0.17     0.16     0.17     0.16     0.04   0.65   0.64   0.65   0.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93980  Penile vascular study                             A   1.25   3.89     3.52     3.89NA   3.52 NA  0.08   5.22   4.85   5.22   4.85  1XXX.00.00.0000000             25.5217 090 99      6.53   6.53   0.09
93980TCPenile vascular study                             A   0.00   3.34     3.03     3.34NA   3.03 NA  0.01   3.35   3.04   3.35   3.04  1XXX.00.00.0000000             25.5217 010 99      5.98   5.98   0.02
9398026Penile vascular study                             A   1.25   0.55     0.49     0.55     0.49     0.07   1.87   1.81   1.87   1.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93981  Penile vascular study                             A   0.44   3.09     2.70     3.09NA   2.70 NA  0.04   3.57   3.18   3.57   3.18  1XXX.00.00.0000000             25.5217 090 99      6.15   6.15   0.05
93981TCPenile vascular study                             A   0.00   2.91     2.53     2.91NA   2.53 NA  0.01   2.92   2.54   2.92   2.54  1XXX.00.00.0000000             25.5217 010 99      5.97   5.97   0.02
9398126Penile vascular study                             A   0.44   0.18     0.17     0.18     0.17     0.03   0.65   0.64   0.65   0.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93982  Aneurysm pressure sens study                      R   0.30   0.92     0.87     0.92NA   0.87 NA  0.05   1.27   1.22   1.27   1.22  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
93990  Doppler flow testing                              A   0.25   5.92     5.89     5.92NA   5.89 NA  0.05   6.22   6.19   6.22   6.19  1XXX.00.00.0000000             25.5217 090 99      3.86   3.86   0.05
93990TCDoppler flow testing                              A   0.00   5.83     5.80     5.83NA   5.80 NA  0.01   5.84   5.81   5.84   5.81  1XXX.00.00.0000000             25.5217 010 99      3.77   3.77   0.01
9399026Doppler flow testing                              A   0.25   0.09     0.09     0.09     0.09     0.04   0.38   0.38   0.38   0.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94002  Vent mgmt inpat init day                          A   1.99   0.52NA   0.60NA   0.52     0.60     0.16   2.67   2.75   2.67   2.75  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94003  Vent mgmt inpat subq day                          A   1.37   0.45NA   0.50NA   0.45     0.50     0.10   1.92   1.97   1.92   1.97  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94004  Vent mgmt nf per day                              A   1.00   0.33NA   0.36NA   0.33     0.36     0.07   1.40   1.43   1.40   1.43  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94005  Home vent mgmt supervision                        B+  1.50   1.10     1.10     1.10NA   1.10 NA  0.10   2.70   2.70   2.70   2.70  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
94010  Breathing capacity test                           A   0.17   0.85     0.83     0.85NA   0.83 NA  0.02   1.04   1.02   1.04   1.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94010TCBreathing capacity test                           A   0.00   0.78     0.76     0.78NA   0.76 NA  0.01   0.79   0.77   0.79   0.77  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9401026Breathing capacity test                           A   0.17   0.07     0.07     0.07     0.07     0.01   0.25   0.25   0.25   0.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94011  Spirometry up to 2 yrs old                        A   2.00   0.77NA   0.77NA   0.77     0.77     0.14   2.91   2.91   2.91   2.91  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94012  Spirmtry w/brnchdil inf-2 yr                      A   3.10   1.16NA   1.16NA   1.16     1.16     0.23   4.49   4.49   4.49   4.49  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94013  Meas lung vol thru 2 yrs                          A   0.66   0.22NA   0.22NA   0.22     0.22     0.04   0.92   0.92   0.92   0.92  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94014  Patient recorded spirometry                       A   0.52   0.91     0.84     0.91NA   0.84 NA  0.02   1.45   1.38   1.45   1.38  4XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
94015  Patient recorded spirometry                       A   0.00   0.72     0.65     0.72NA   0.65 NA  0.01   0.73   0.66   0.73   0.66  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
94016  Review patient spirometry                         A   0.52   0.19     0.19     0.19     0.19     0.01   0.72   0.72   0.72   0.72  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94060  Evaluation of wheezing                            A   0.31   1.47     1.44     1.47NA   1.44 NA  0.02   1.80   1.77   1.80   1.77  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94060TCEvaluation of wheezing                            A   0.00   1.36     1.32     1.36NA   1.32 NA  0.01   1.37   1.33   1.37   1.33  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9406026Evaluation of wheezing                            A   0.31   0.11     0.12     0.11     0.12     0.01   0.43   0.44   0.43   0.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94070  Evaluation of wheezing                            A   0.60   1.13     1.11     1.13NA   1.11 NA  0.04   1.77   1.75   1.77   1.75  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94070TCEvaluation of wheezing                            A   0.00   0.92     0.88     0.92NA   0.88 NA  0.01   0.93   0.89   0.93   0.89  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9407026Evaluation of wheezing                            A   0.60   0.21     0.23     0.21     0.23     0.03   0.84   0.86   0.84   0.86  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94150  Vital capacity test                               B+  0.07   0.63     0.61     0.63NA   0.61 NA  0.02   0.72   0.70   0.72   0.70  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
94150TCVital capacity test                               B+  0.00   0.60     0.58     0.60NA   0.58 NA  0.01   0.61   0.59   0.61   0.59  1XXX.00.00.0099999             25.5217 010 99      0.00   0.00   0.00
9415026Vital capacity test                               B+  0.07   0.03     0.03     0.03     0.03     0.01   0.11   0.11   0.11   0.11  1XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
94200  Lung function test (MBC/MVV)                      A   0.11   0.58     0.57     0.58NA   0.57 NA  0.02   0.71   0.70   0.71   0.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94200TCLung function test (MBC/MVV)                      A   0.00   0.54     0.53     0.54NA   0.53 NA  0.01   0.55   0.54   0.55   0.54  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9420026Lung function test (MBC/MVV)                      A   0.11   0.04     0.04     0.04     0.04     0.01   0.16   0.16   0.16   0.16  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94240  Residual lung capacity                            A   0.26   0.90     0.86     0.90NA   0.86 NA  0.02   1.18   1.14   1.18   1.14  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94240TCResidual lung capacity                            A   0.00   0.81     0.77     0.81NA   0.77 NA  0.01   0.82   0.78   0.82   0.78  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9424026Residual lung capacity                            A   0.26   0.09     0.09     0.09     0.09     0.01   0.36   0.36   0.36   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94250  Expired gas collection                            A   0.11   0.62     0.57     0.62NA   0.57 NA  0.02   0.75   0.70   0.75   0.70  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94250TCExpired gas collection                            A   0.00   0.58     0.53     0.58NA   0.53 NA  0.01   0.59   0.54   0.59   0.54  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9425026Expired gas collection                            A   0.11   0.04     0.04     0.04     0.04     0.01   0.16   0.16   0.16   0.16  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94260  Thoracic gas volume                               A   0.13   0.81     0.78     0.81NA   0.78 NA  0.02   0.96   0.93   0.96   0.93  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94260TCThoracic gas volume                               A   0.00   0.77     0.73     0.77NA   0.73 NA  0.01   0.78   0.74   0.78   0.74  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9426026Thoracic gas volume                               A   0.13   0.04     0.05     0.04     0.05     0.01   0.18   0.19   0.18   0.19  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94350  Lung nitrogen washout curve                       A   0.26   0.74     0.69     0.74NA   0.69 NA  0.02   1.02   0.97   1.02   0.97  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94350TCLung nitrogen washout curve                       A   0.00   0.65     0.59     0.65NA   0.59 NA  0.01   0.66   0.60   0.66   0.60  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9435026Lung nitrogen washout curve                       A   0.26   0.09     0.10     0.09     0.10     0.01   0.36   0.37   0.36   0.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94360  Measure airflow resistance                        A   0.26   1.03     1.00     1.03NA   1.00 NA  0.02   1.31   1.28   1.31   1.28  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94360TCMeasure airflow resistance                        A   0.00   0.94     0.91     0.94NA   0.91 NA  0.01   0.95   0.92   0.95   0.92  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9436026Measure airflow resistance                        A   0.26   0.09     0.09     0.09     0.09     0.01   0.36   0.36   0.36   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94370  Breath airway closing volume                      A   0.26   0.73     0.69     0.73NA   0.69 NA  0.02   1.01   0.97   1.01   0.97  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94370TCBreath airway closing volume                      A   0.00   0.64     0.59     0.64NA   0.59 NA  0.01   0.65   0.60   0.65   0.60  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9437026Breath airway closing volume                      A   0.26   0.09     0.10     0.09     0.10     0.01   0.36   0.37   0.36   0.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94375  Respiratory flow volume loop                      A   0.31   0.81     0.78     0.81NA   0.78 NA  0.02   1.14   1.11   1.14   1.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94375TCRespiratory flow volume loop                      A   0.00   0.70     0.66     0.70NA   0.66 NA  0.01   0.71   0.67   0.71   0.67  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9437526Respiratory flow volume loop                      A   0.31   0.11     0.12     0.11     0.12     0.01   0.43   0.44   0.43   0.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94400  CO2 breathing response curve                      A   0.40   1.17     1.14     1.17NA   1.14 NA  0.02   1.59   1.56   1.59   1.56  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94400TCCO2 breathing response curve                      A   0.00   1.03     1.00     1.03NA   1.00 NA  0.01   1.04   1.01   1.04   1.01  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9440026CO2 breathing response curve                      A   0.40   0.14     0.14     0.14     0.14     0.01   0.55   0.55   0.55   0.55  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94450  Hypoxia response curve                            A   0.40   1.33     1.48     1.33NA   1.48 NA  0.02   1.75   1.90   1.75   1.90  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94450TCHypoxia response curve                            A   0.00   1.18     1.31     1.18NA   1.31 NA  0.01   1.19   1.32   1.19   1.32  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9445026Hypoxia response curve                            A   0.40   0.15     0.17     0.15     0.17     0.01   0.56   0.58   0.56   0.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94452  Hast w/report                                     A   0.31   1.37     1.29     1.37NA   1.29 NA  0.02   1.70   1.62   1.70   1.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94452TCHast w/report                                     A   0.00   1.27     1.18     1.27NA   1.18 NA  0.01   1.28   1.19   1.28   1.19  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9445226Hast w/report                                     A   0.31   0.10     0.11     0.10     0.11     0.01   0.42   0.43   0.42   0.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94453  Hast w/oxygen titrate                             A   0.40   1.87     1.78     1.87NA   1.78 NA  0.02   2.29   2.20   2.29   2.20  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94453TCHast w/oxygen titrate                             A   0.00   1.73     1.64     1.73NA   1.64 NA  0.01   1.74   1.65   1.74   1.65  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9445326Hast w/oxygen titrate                             A   0.40   0.14     0.14     0.14     0.14     0.01   0.55   0.55   0.55   0.55  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94610  Surfactant admin thru tube                        A   1.16   0.51     0.57     0.51     0.57     0.07   1.74   1.80   1.74   1.80  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94620  Pulmonary stress test/simple                      A   0.64   1.19     0.89     1.19NA   0.89 NA  0.04   1.87   1.57   1.87   1.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94620TCPulmonary stress test/simple                      A   0.00   0.96     0.66     0.96NA   0.66 NA  0.01   0.97   0.67   0.97   0.67  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9462026Pulmonary stress test/simple                      A   0.64   0.23     0.23     0.23     0.23     0.03   0.90   0.90   0.90   0.90  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94621  Pulm stress test/complex                          A   1.42   3.33     3.12     3.33NA   3.12 NA  0.06   4.81   4.60   4.81   4.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94621TCPulm stress test/complex                          A   0.00   2.77     2.59     2.77NA   2.59 NA  0.01   2.78   2.60   2.78   2.60  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9462126Pulm stress test/complex                          A   1.42   0.56     0.53     0.56     0.53     0.05   2.03   2.00   2.03   2.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94640  Airway inhalation treatment                       A   0.00   0.46     0.49     0.46NA   0.49 NA  0.01   0.47   0.50   0.47   0.50  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94642  Aerosol inhalation treatment                      C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94644  Cbt 1st hour                                      A   0.00   1.17     1.22     1.17NA   1.22 NA  0.01   1.18   1.23   1.18   1.23  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94645  Cbt each addl hour                                A   0.00   0.42     0.40     0.42NA   0.40 NA  0.01   0.43   0.41   0.43   0.41  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94660  Pos airway pressure cpap                          A   0.76   0.94     0.96     0.27     0.30     0.05   1.75   1.77   1.08   1.11  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94662  Neg press ventilation cnp                         A   0.76   0.26NA   0.26NA   0.26     0.26     0.05   1.07   1.07   1.07   1.07  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94664  Evaluate pt use of inhaler                        A   0.00   0.46     0.47     0.46NA   0.47 NA  0.01   0.47   0.48   0.47   0.48  5XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
94667  Chest wall manipulation                           A   0.00   0.66     0.67     0.66NA   0.67 NA  0.01   0.67   0.68   0.67   0.68  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94668  Chest wall manipulation                           A   0.00   0.63     0.64     0.63NA   0.64 NA  0.01   0.64   0.65   0.64   0.65  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94680  Exhaled air analysis o2                           A   0.26   1.45     1.36     1.45NA   1.36 NA  0.02   1.73   1.64   1.73   1.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94680TCExhaled air analysis o2                           A   0.00   1.35     1.25     1.35NA   1.25 NA  0.01   1.36   1.26   1.36   1.26  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9468026Exhaled air analysis o2                           A   0.26   0.10     0.11     0.10     0.11     0.01   0.37   0.38   0.37   0.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94681  Exhaled air analysis o2/co2                       A   0.20   1.46     1.20     1.46NA   1.20 NA  0.02   1.68   1.42   1.68   1.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94681TCExhaled air analysis o2/co2                       A   0.00   1.39     1.12     1.39NA   1.12 NA  0.01   1.40   1.13   1.40   1.13  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9468126Exhaled air analysis o2/co2                       A   0.20   0.07     0.08     0.07     0.08     0.01   0.28   0.29   0.28   0.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94690  Exhaled air analysis                              A   0.07   1.44     1.32     1.44NA   1.32 NA  0.02   1.53   1.41   1.53   1.41  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94690TCExhaled air analysis                              A   0.00   1.41     1.29     1.41NA   1.29 NA  0.01   1.42   1.30   1.42   1.30  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9469026Exhaled air analysis                              A   0.07   0.03     0.03     0.03     0.03     0.01   0.11   0.11   0.11   0.11  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94720  Monoxide diffusing capacity                       A   0.26   1.27     1.19     1.27NA   1.19 NA  0.02   1.55   1.47   1.55   1.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94720TCMonoxide diffusing capacity                       A   0.00   1.18     1.10     1.18NA   1.10 NA  0.01   1.19   1.11   1.19   1.11  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9472026Monoxide diffusing capacity                       A   0.26   0.09     0.09     0.09     0.09     0.01   0.36   0.36   0.36   0.36  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94725  Membrane diffusion capacity                       A   0.26   1.48     1.17     1.48NA   1.17 NA  0.02   1.76   1.45   1.76   1.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94725TCMembrane diffusion capacity                       A   0.00   1.38     1.07     1.38NA   1.07 NA  0.01   1.39   1.08   1.39   1.08  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9472526Membrane diffusion capacity                       A   0.26   0.10     0.10     0.10     0.10     0.01   0.37   0.37   0.37   0.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94750  Pulmonary compliance study                        A   0.23   2.05     2.04     2.05NA   2.04 NA  0.02   2.30   2.29   2.30   2.29  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94750TCPulmonary compliance study                        A   0.00   1.97     1.95     1.97NA   1.95 NA  0.01   1.98   1.96   1.98   1.96  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9475026Pulmonary compliance study                        A   0.23   0.08     0.09     0.08     0.09     0.01   0.32   0.33   0.32   0.33  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94760  Measure blood oxygen level                        T   0.00   0.07     0.08     0.07NA   0.08 NA  0.01   0.08   0.09   0.08   0.09  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
94761  Measure blood oxygen level                        T   0.00   0.12     0.12     0.12NA   0.12 NA  0.01   0.13   0.13   0.13   0.13  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
94762  Measure blood oxygen level                        A   0.00   0.58     0.29     0.58NA   0.29 NA  0.01   0.59   0.30   0.59   0.30  3XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
94770  Exhaled carbon dioxide test                       A   0.15   0.50     0.07     0.50     0.07     0.02   0.67   0.24   0.67   0.24  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94772  Breath recording infant                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94772TCBreath recording infant                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9477226Breath recording infant                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94774  Ped home apnea rec compl                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  4YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94775  Ped home apnea rec hk-up                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94776  Ped home apnea rec downld                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  3YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94777  Ped home apnea rec report                         C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  2YYY.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94799  Pulmonary service/procedure                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
94799TCPulmonary service/procedure                       C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9479926Pulmonary service/procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95004  Percut allergy skin tests                         A   0.01   0.17     0.17     0.17NA   0.17 NA  0.01   0.19   0.19   0.19   0.19  0XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
95010  Percut allergy titrate test                       A   0.15   0.38     0.38     0.38NA   0.38 NA  0.01   0.54   0.54   0.54   0.54  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95012  Exhaled nitric oxide meas                         A   0.00   0.60     0.55     0.60NA   0.55 NA  0.01   0.61   0.56   0.61   0.56  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95015  Id allergy titrate-drug/bug                       A   0.15   0.26     0.29     0.07     0.07     0.01   0.42   0.45   0.23   0.23  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95024  Id allergy test drug/bug                          A   0.01   0.20     0.19     0.20NA   0.19 NA  0.01   0.22   0.21   0.22   0.21  0XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
95027  Id allergy titrate-airborne                       A   0.01   0.12     0.11     0.12NA   0.11 NA  0.01   0.14   0.13   0.14   0.13  0XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
95028  Id allergy test-delayed type                      A   0.00   0.37     0.38     0.37NA   0.38 NA  0.01   0.38   0.39   0.38   0.39  3XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
95044  Allergy patch tests                               A   0.00   0.17     0.15     0.17NA   0.15 NA  0.01   0.18   0.16   0.18   0.16  5XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
95052  Photo patch test                                  A   0.00   0.20     0.17     0.20NA   0.17 NA  0.01   0.21   0.18   0.21   0.18  5XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
95056  Photosensitivity tests                            A   0.00   1.20     1.24     1.20NA   1.24 NA  0.01   1.21   1.25   1.21   1.25  5XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
95060  Eye allergy tests                                 A   0.00   0.84     0.91     0.84     0.91     0.01   0.85   0.92   0.85   0.92  3XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
95065  Nose allergy test                                 A   0.00   0.71     0.72     0.71     0.72     0.01   0.72   0.73   0.72   0.73  3XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
95070  Bronchial allergy tests                           A   0.00   1.11     0.81     1.11NA   0.81 NA  0.01   1.12   0.82   1.12   0.82  3XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
95071  Bronchial allergy tests                           A   0.00   1.50     1.24     1.50NA   1.24 NA  0.01   1.51   1.25   1.51   1.25  3XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
95075  Ingestion challenge test                          A   0.95   0.91     0.91     0.42     0.44     0.04   1.90   1.90   1.41   1.43  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95115  Immunotherapy one injection                       A   0.00   0.29     0.26     0.29NA   0.26 NA  0.01   0.30   0.27   0.30   0.27  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95117  Immunotherapy injections                          A   0.00   0.36     0.31     0.36NA   0.31 NA  0.01   0.37   0.32   0.37   0.32  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95120  Immunotherapy one injection                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
95125  Immunotherapy many antigens                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
95130  Immunotherapy insect venom                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
95131  Immunotherapy insect venoms                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
95132  Immunotherapy insect venoms                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
95133  Immunotherapy insect venoms                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
95134  Immunotherapy insect venoms                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
95144  Antigen therapy services                          A   0.06   0.30     0.30     0.03     0.03     0.01   0.37   0.37   0.10   0.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95145  Antigen therapy services                          A   0.06   0.49     0.56     0.03     0.03     0.01   0.56   0.63   0.10   0.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95146  Antigen therapy services                          A   0.06   0.91     1.06     0.03     0.03     0.01   0.98   1.13   0.10   0.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95147  Antigen therapy services                          A   0.06   0.85     0.96     0.03     0.03     0.01   0.92   1.03   0.10   0.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95148  Antigen therapy services                          A   0.06   1.27     1.46     0.03     0.03     0.01   1.34   1.53   0.10   0.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95149  Antigen therapy services                          A   0.06   1.71     1.98     0.03     0.03     0.01   1.78   2.05   0.10   0.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95165  Antigen therapy services                          A   0.06   0.30     0.30     0.03     0.03     0.01   0.37   0.37   0.10   0.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95170  Antigen therapy services                          A   0.06   0.22     0.21     0.03     0.03     0.01   0.29   0.28   0.10   0.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95180  Rapid desensitization                             A   2.01   2.08     1.95     1.03     1.00     0.07   4.16   4.03   3.11   3.08  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95199  Allergy immunology services                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95250  Glucose monitoring cont                           A   0.00   4.36     4.37     4.36NA   4.37 NA  0.01   4.37   4.38   4.37   4.38  3XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95251  Gluc monitor cont phys i&r                        A   0.85   0.34     0.39     0.34     0.39     0.04   1.23   1.28   1.23   1.28  2XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95800  Slp stdy unattended                               A   1.05  37.51    37.51    37.51NA  37.51 NA  0.05  38.61  38.61  38.61  38.61  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95800TCSlp stdy unattended                               A   0.00  36.89    36.89    36.89NA  36.89 NA  0.01  36.90  36.90  36.90  36.90  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9580026Slp stdy unattended                               A   1.05   0.62     0.62     0.62     0.62     0.04   1.71   1.71   1.71   1.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95801  Slp stdy unatnd w/anal                            A   1.00  64.32    64.32    64.32NA  64.32 NA  0.05  65.37  65.37  65.37  65.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95801TCSlp stdy unatnd w/anal                            A   0.00  63.85    63.85    63.85NA  63.85 NA  0.01  63.86  63.86  63.86  63.86  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9580126Slp stdy unatnd w/anal                            A   1.00   0.47     0.47     0.47     0.47     0.04   1.51   1.51   1.51   1.51  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95803  Actigraphy testing                                A   0.90   3.84     3.84     3.84NA   3.84 NA  0.04   4.78   4.78   4.78   4.78  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95803TCActigraphy testing                                A   0.00   3.40     3.40     3.40NA   3.40 NA  0.01   3.41   3.41   3.41   3.41  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9580326Actigraphy testing                                A   0.90   0.44     0.44     0.44     0.44     0.03   1.37   1.37   1.37   1.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95805  Multiple sleep latency test                       A   1.20  10.84    10.18    10.84NA  10.18 NA  0.08  12.12  11.46  12.12  11.46  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95805TCMultiple sleep latency test                       A   0.00  10.26     9.70    10.26NA   9.70 NA  0.04  10.30   9.74  10.30   9.74  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9580526Multiple sleep latency test                       A   1.20   0.58     0.48     0.58     0.48     0.04   1.82   1.72   1.82   1.72  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95806  Sleep study unatt&resp efft                       A   1.25   4.05     3.50     4.05NA   3.50 NA  0.08   5.38   4.83   5.38   4.83  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95806TCSleep study unatt&resp efft                       A   0.00   3.50     3.01     3.50NA   3.01 NA  0.03   3.53   3.04   3.53   3.04  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9580626Sleep study unatt&resp efft                       A   1.25   0.55     0.49     0.55     0.49     0.05   1.85   1.79   1.85   1.79  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95807  Sleep study attended                              A   1.28  12.45    10.80    12.45NA  10.80 NA  0.15  13.88  12.23  13.88  12.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95807TCSleep study attended                              A   0.00  11.92    10.33    11.92NA  10.33 NA  0.10  12.02  10.43  12.02  10.43  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9580726Sleep study attended                              A   1.28   0.53     0.47     0.53     0.47     0.05   1.86   1.80   1.86   1.80  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95808  Polysomnography 1-3                               A   1.74  17.28    16.53    17.28NA  16.53 NA  0.17  19.19  18.44  19.19  18.44  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95808TCPolysomnography 1-3                               A   0.00  16.44    15.80    16.44NA  15.80 NA  0.10  16.54  15.90  16.54  15.90  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9580826Polysomnography 1-3                               A   1.74   0.84     0.73     0.84     0.73     0.07   2.65   2.54   2.65   2.54  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95810  Polysomnography 4 or more                         A   2.50  17.80    14.60    17.80NA  14.60 NA  0.21  20.51  17.31  20.51  17.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95810TCPolysomnography 4 or more                         A   0.00  16.70    13.63    16.70NA  13.63 NA  0.11  16.81  13.74  16.81  13.74  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9581026Polysomnography 4 or more                         A   2.50   1.10     0.97     1.10     0.97     0.10   3.70   3.57   3.70   3.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95811  Polysomnography w/cpap                            A   2.60  19.30    15.34    19.30NA  15.34 NA  0.23  22.13  18.17  22.13  18.17  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95811TCPolysomnography w/cpap                            A   0.00  18.15    14.34    18.15NA  14.34 NA  0.12  18.27  14.46  18.27  14.46  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9581126Polysomnography w/cpap                            A   2.60   1.15     1.00     1.15     1.00     0.11   3.86   3.71   3.86   3.71  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95812  Eeg 41-60 minutes                                 A   1.08   8.16     9.79     8.16NA   9.79 NA  0.07   9.31  10.94   9.31  10.94  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95812TCEeg 41-60 minutes                                 A   0.00   7.68     9.27     7.68NA   9.27 NA  0.03   7.71   9.30   7.71   9.30  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9581226Eeg 41-60 minutes                                 A   1.08   0.48     0.52     0.48     0.52     0.04   1.60   1.64   1.60   1.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95813  Eeg over 1 hour                                   A   1.73   8.64     9.79     8.64NA   9.79 NA  0.11  10.48  11.63  10.48  11.63  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95813TCEeg over 1 hour                                   A   0.00   7.90     8.99     7.90NA   8.99 NA  0.04   7.94   9.03   7.94   9.03  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9581326Eeg over 1 hour                                   A   1.73   0.74     0.80     0.74     0.80     0.07   2.54   2.60   2.54   2.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95816  Eeg awake and drowsy                              A   1.08   7.46     9.02     7.46NA   9.02 NA  0.08   8.62  10.18   8.62  10.18  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95816TCEeg awake and drowsy                              A   0.00   6.98     8.50     6.98NA   8.50 NA  0.03   7.01   8.53   7.01   8.53  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9581626Eeg awake and drowsy                              A   1.08   0.48     0.52     0.48     0.52     0.05   1.61   1.65   1.61   1.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95819  Eeg awake and asleep                              A   1.08   8.47    10.49     8.47NA  10.49 NA  0.07   9.62  11.64   9.62  11.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95819TCEeg awake and asleep                              A   0.00   7.99     9.97     7.99NA   9.97 NA  0.03   8.02  10.00   8.02  10.00  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9581926Eeg awake and asleep                              A   1.08   0.48     0.52     0.48     0.52     0.04   1.60   1.64   1.60   1.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95822  Eeg coma or sleep only                            A   1.08   7.84     9.31     7.84NA   9.31 NA  0.07   8.99  10.46   8.99  10.46  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95822TCEeg coma or sleep only                            A   0.00   7.36     8.79     7.36NA   8.79 NA  0.03   7.39   8.82   7.39   8.82  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9582226Eeg coma or sleep only                            A   1.08   0.48     0.52     0.48     0.52     0.04   1.60   1.64   1.60   1.64  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95824  Eeg cerebral death only                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95824TCEeg cerebral death only                           C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9582426Eeg cerebral death only                           A   0.74   0.33     0.35     0.33     0.35     0.05   1.12   1.14   1.12   1.14  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95827  Eeg all night recording                           A   1.08  15.31    19.36    15.31NA  19.36 NA  0.13  16.52  20.57  16.52  20.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95827TCEeg all night recording                           A   0.00  14.84    18.83    14.84NA  18.83 NA  0.08  14.92  18.91  14.92  18.91  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9582726Eeg all night recording                           A   1.08   0.47     0.53     0.47     0.53     0.05   1.60   1.66   1.60   1.66  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95829  Surgery electrocorticogram                        A   6.20  37.71    42.66    37.71NA  42.66 NA  0.21  44.12  49.07  44.12  49.07  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95829TCSurgery electrocorticogram                        A   0.00  34.96    39.65    34.96NA  39.65 NA  0.05  35.01  39.70  35.01  39.70  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9582926Surgery electrocorticogram                        A   6.20   2.75     3.01     2.75     3.01     0.16   9.11   9.37   9.11   9.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95830  Insert electrodes for EEG                         A   1.70   3.79     3.87     0.71     0.75     0.14   5.63   5.71   2.55   2.59  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95831  Limb muscle testing manual                        A   0.28   0.54     0.57     0.13     0.14     0.03   0.85   0.88   0.44   0.45  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95832  Hand muscle testing manual                        A   0.29   0.50     0.57     0.14     0.17     0.03   0.82   0.89   0.46   0.49  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95833  Body muscle testing manual                        A   0.47   0.60     0.61     0.18     0.16     0.01   1.08   1.09   0.66   0.64  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95834  Body muscle testing manual                        A   0.60   0.73     0.82     0.25     0.26     0.03   1.36   1.45   0.88   0.89  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95851  Range of motion measurements                      A   0.16   0.34     0.35     0.06     0.06     0.01   0.51   0.52   0.23   0.23  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95852  Range of motion measurements                      A   0.11   0.32     0.35     0.05     0.05     0.01   0.44   0.47   0.17   0.17  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95857  Cholinesterase challenge                          A   0.53   0.82     0.92     0.27     0.30     0.04   1.39   1.49   0.84   0.87  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95860  Muscle test one limb                              A   0.96   1.67     1.84     1.67NA   1.84 NA  0.04   2.67   2.84   2.67   2.84  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95860TCMuscle test one limb                              A   0.00   1.20     1.34     1.20NA   1.34 NA  0.01   1.21   1.35   1.21   1.35  1XXX.00.00.0000000             25.5217 6A0 99      0.00   0.00   0.00
9586026Muscle test one limb                              A   0.96   0.47     0.50     0.47     0.50     0.03   1.46   1.49   1.46   1.49  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95861  Muscle test 2 limbs                               A   1.54   2.26     2.60     2.26NA   2.60 NA  0.06   3.86   4.20   3.86   4.20  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95861TCMuscle test 2 limbs                               A   0.00   1.52     1.80     1.52NA   1.80 NA  0.01   1.53   1.81   1.53   1.81  1XXX.00.00.0000000             25.5217 6A0 99      0.00   0.00   0.00
9586126Muscle test 2 limbs                               A   1.54   0.74     0.80     0.74     0.80     0.05   2.33   2.39   2.33   2.39  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95863  Muscle test 3 limbs                               A   1.87   2.73     3.17     2.73NA   3.17 NA  0.08   4.68   5.12   4.68   5.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95863TCMuscle test 3 limbs                               A   0.00   1.86     2.23     1.86NA   2.23 NA  0.01   1.87   2.24   1.87   2.24  1XXX.00.00.0000000             25.5217 6A0 99      0.00   0.00   0.00
9586326Muscle test 3 limbs                               A   1.87   0.87     0.94     0.87     0.94     0.07   2.81   2.88   2.81   2.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95864  Muscle test 4 limbs                               A   1.99   3.06     3.35     3.06NA   3.35 NA  0.08   5.13   5.42   5.13   5.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95864TCMuscle test 4 limbs                               A   0.00   2.13     2.35     2.13NA   2.35 NA  0.01   2.14   2.36   2.14   2.36  1XXX.00.00.0000000             25.5217 6A0 99      0.00   0.00   0.00
9586426Muscle test 4 limbs                               A   1.99   0.93     1.00     0.93     1.00     0.07   2.99   3.06   2.99   3.06  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95865  Muscle test larynx                                A   1.57   1.90     2.06     1.90NA   2.06 NA  0.05   3.52   3.68   3.52   3.68  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95865TCMuscle test larynx                                A   0.00   1.12     1.22     1.12NA   1.22 NA  0.01   1.13   1.23   1.13   1.23  1XXX.00.00.0002000             25.5217 6A0 99      0.00   0.00   0.00
9586526Muscle test larynx                                A   1.57   0.78     0.84     0.78     0.84     0.04   2.39   2.45   2.39   2.45  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95866  Muscle test hemidiaphragm                         A   1.25   1.75     2.03     1.75NA   2.03 NA  0.06   3.06   3.34   3.06   3.34  1XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
95866TCMuscle test hemidiaphragm                         A   0.00   1.16     1.42     1.16NA   1.42 NA  0.01   1.17   1.43   1.17   1.43  1XXX.00.00.0001000             25.5217 6A0 99      0.00   0.00   0.00
9586626Muscle test hemidiaphragm                         A   1.25   0.59     0.61     0.59     0.61     0.05   1.89   1.91   1.89   1.91  1XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
95867  Muscle test cran nerv unilat                      A   0.79   1.54     1.74     1.54NA   1.74 NA  0.04   2.37   2.57   2.37   2.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95867TCMuscle test cran nerv unilat                      A   0.00   1.16     1.33     1.16NA   1.33 NA  0.01   1.17   1.34   1.17   1.34  1XXX.00.00.0000000             25.5217 6A0 99      0.00   0.00   0.00
9586726Muscle test cran nerv unilat                      A   0.79   0.38     0.41     0.38     0.41     0.03   1.20   1.23   1.20   1.23  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95868  Muscle test cran nerve bilat                      A   1.18   1.98     2.26     1.98NA   2.26 NA  0.05   3.21   3.49   3.21   3.49  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95868TCMuscle test cran nerve bilat                      A   0.00   1.43     1.66     1.43NA   1.66 NA  0.01   1.44   1.67   1.44   1.67  1XXX.00.00.0002000             25.5217 6A0 99      0.00   0.00   0.00
9586826Muscle test cran nerve bilat                      A   1.18   0.55     0.60     0.55     0.60     0.04   1.77   1.82   1.77   1.82  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95869  Muscle test thor paraspinal                       A   0.37   1.34     1.63     1.34NA   1.63 NA  0.02   1.73   2.02   1.73   2.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95869TCMuscle test thor paraspinal                       A   0.00   1.16     1.44     1.16NA   1.44 NA  0.01   1.17   1.45   1.17   1.45  1XXX.00.00.0000000             25.5217 6A0 99      0.00   0.00   0.00
9586926Muscle test thor paraspinal                       A   0.37   0.18     0.19     0.18     0.19     0.01   0.56   0.57   0.56   0.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95870  Muscle test nonparaspinal                         A   0.37   1.29     1.60     1.29NA   1.60 NA  0.02   1.68   1.99   1.68   1.99  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95870TCMuscle test nonparaspinal                         A   0.00   1.12     1.41     1.12NA   1.41 NA  0.01   1.13   1.42   1.13   1.42  1XXX.00.00.0000000             25.5217 6A0 99      0.00   0.00   0.00
9587026Muscle test nonparaspinal                         A   0.37   0.17     0.19     0.17     0.19     0.01   0.55   0.57   0.55   0.57  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95872  Muscle test one fiber                             A   2.88   2.25     2.58     2.25NA   2.58 NA  0.12   5.25   5.58   5.25   5.58  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95872TCMuscle test one fiber                             A   0.00   1.03     1.20     1.03NA   1.20 NA  0.01   1.04   1.21   1.04   1.21  1XXX.00.00.0000000             25.5217 660 99      0.00   0.00   0.00
9587226Muscle test one fiber                             A   2.88   1.22     1.38     1.22     1.38     0.11   4.21   4.37   4.21   4.37  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95873  Guide nerv destr elec stim                        A   0.37   1.34     1.61     1.34NA   1.61 NA  0.02   1.73   2.00   1.73   2.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95873TCGuide nerv destr elec stim                        A   0.00   1.13     1.40     1.13NA   1.40 NA  0.01   1.14   1.41   1.14   1.41  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9587326Guide nerv destr elec stim                        A   0.37   0.21     0.21     0.21     0.21     0.01   0.59   0.59   0.59   0.59  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95874  Guide nerv destr needle emg                       A   0.37   1.25     1.54     1.25NA   1.54 NA  0.02   1.64   1.93   1.64   1.93  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95874TCGuide nerv destr needle emg                       A   0.00   1.07     1.34     1.07NA   1.34 NA  0.01   1.08   1.35   1.08   1.35  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9587426Guide nerv destr needle emg                       A   0.37   0.18     0.20     0.18     0.20     0.01   0.56   0.58   0.56   0.58  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95875  Limb exercise test                                A   1.10   1.94     2.22     1.94NA   2.22 NA  0.06   3.10   3.38   3.10   3.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95875TCLimb exercise test                                A   0.00   1.44     1.69     1.44NA   1.69 NA  0.01   1.45   1.70   1.45   1.70  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9587526Limb exercise test                                A   1.10   0.50     0.53     0.50     0.53     0.05   1.65   1.68   1.65   1.68  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95900  Motor nerve conduction test                       A   0.42   1.33     1.45     1.33NA   1.45 NA  0.02   1.77   1.89   1.77   1.89  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95900TCMotor nerve conduction test                       A   0.00   1.13     1.23     1.13NA   1.23 NA  0.01   1.14   1.24   1.14   1.24  1XXX.00.00.0000000             25.5217 7A0 99      0.00   0.00   0.00
9590026Motor nerve conduction test                       A   0.42   0.20     0.22     0.20     0.22     0.01   0.63   0.65   0.63   0.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95903  Motor nerve conduction test                       A   0.60   1.42     1.54     1.42NA   1.54 NA  0.04   2.06   2.18   2.06   2.18  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95903TCMotor nerve conduction test                       A   0.00   1.15     1.25     1.15NA   1.25 NA  0.01   1.16   1.26   1.16   1.26  1XXX.00.00.0000000             25.5217 7A0 99      0.00   0.00   0.00
9590326Motor nerve conduction test                       A   0.60   0.27     0.29     0.27     0.29     0.03   0.90   0.92   0.90   0.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95904  Sense nerve conduction test                       A   0.34   1.20     1.29     1.20NA   1.29 NA  0.02   1.56   1.65   1.56   1.65  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95904TCSense nerve conduction test                       A   0.00   1.04     1.12     1.04NA   1.12 NA  0.01   1.05   1.13   1.05   1.13  1XXX.00.00.0000000             25.5217 7A0 99      0.00   0.00   0.00
9590426Sense nerve conduction test                       A   0.34   0.16     0.17     0.16     0.17     0.01   0.51   0.52   0.51   0.52  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95905  Motor/sens nrve conduct test                      A   0.05   2.42     2.42     2.42NA   2.42 NA  0.02   2.49   2.49   2.49   2.49  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95905TCMotor/sens nrve conduct test                      A   0.00   2.39     2.39     2.39NA   2.39 NA  0.01   2.40   2.40   2.40   2.40  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9590526Motor/sens nrve conduct test                      A   0.05   0.03     0.03     0.03     0.03     0.01   0.09   0.09   0.09   0.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95920  Intraop nerve test add-on                         A   2.11   2.47     2.70     2.47NA   2.70 NA  0.09   4.67   4.90   4.67   4.90  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95920TCIntraop nerve test add-on                         A   0.00   1.52     1.67     1.52NA   1.67 NA  0.01   1.53   1.68   1.53   1.68  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9592026Intraop nerve test add-on                         A   2.11   0.95     1.03     0.95     1.03     0.08   3.14   3.22   3.14   3.22  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95921  Autonomic nerv function test                      A   0.90   1.41     1.53     1.41NA   1.53 NA  0.04   2.35   2.47   2.35   2.47  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95921TCAutonomic nerv function test                      A   0.00   1.03     1.12     1.03NA   1.12 NA  0.01   1.04   1.13   1.04   1.13  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9592126Autonomic nerv function test                      A   0.90   0.38     0.41     0.38     0.41     0.03   1.31   1.34   1.31   1.34  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95922  Autonomic nerv function test                      A   0.96   1.90     2.10     1.90NA   2.10 NA  0.04   2.90   3.10   2.90   3.10  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95922TCAutonomic nerv function test                      A   0.00   1.49     1.66     1.49NA   1.66 NA  0.01   1.50   1.67   1.50   1.67  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9592226Autonomic nerv function test                      A   0.96   0.41     0.44     0.41     0.44     0.03   1.40   1.43   1.40   1.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95923  Autonomic nerv function test                      A   0.90   3.33     3.93     3.33NA   3.93 NA  0.05   4.28   4.88   4.28   4.88  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95923TCAutonomic nerv function test                      A   0.00   2.92     3.49     2.92NA   3.49 NA  0.01   2.93   3.50   2.93   3.50  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9592326Autonomic nerv function test                      A   0.90   0.41     0.44     0.41     0.44     0.04   1.35   1.38   1.35   1.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95925  Somatosensory testing                             A   0.54   4.07     4.94     4.07NA   4.94 NA  0.02   4.63   5.50   4.63   5.50  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95925TCSomatosensory testing                             A   0.00   3.83     4.68     3.83NA   4.68 NA  0.01   3.84   4.69   3.84   4.69  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
9592526Somatosensory testing                             A   0.54   0.24     0.26     0.24     0.26     0.01   0.79   0.81   0.79   0.81  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95926  Somatosensory testing                             A   0.54   3.90     4.66     3.90NA   4.66 NA  0.04   4.48   5.24   4.48   5.24  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95926TCSomatosensory testing                             A   0.00   3.66     4.41     3.66NA   4.41 NA  0.01   3.67   4.42   3.67   4.42  1XXX.00.00.0002000             25.5217 210 99      0.00   0.00   0.00
9592626Somatosensory testing                             A   0.54   0.24     0.25     0.24     0.25     0.03   0.81   0.82   0.81   0.82  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95927  Somatosensory testing                             A   0.54   3.64     4.06     3.64NA   4.06 NA  0.02   4.20   4.62   4.20   4.62  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95927TCSomatosensory testing                             A   0.00   3.39     3.80     3.39NA   3.80 NA  0.01   3.40   3.81   3.40   3.81  1XXX.00.00.0000000             25.5217 210 99      0.00   0.00   0.00
9592726Somatosensory testing                             A   0.54   0.25     0.26     0.25     0.26     0.01   0.80   0.81   0.80   0.81  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95928  C motor evoked uppr limbs                         A   1.50   5.31     6.24     5.31NA   6.24 NA  0.10   6.91   7.84   6.91   7.84  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95928TCC motor evoked uppr limbs                         A   0.00   4.64     5.51     4.64NA   5.51 NA  0.03   4.67   5.54   4.67   5.54  1XXX.00.00.0000000             25.5217 210 99      0.00   0.00   0.00
9592826C motor evoked uppr limbs                         A   1.50   0.67     0.73     0.67     0.73     0.07   2.24   2.30   2.24   2.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95929  C motor evoked lwr limbs                          A   1.50   5.71     6.70     5.71NA   6.70 NA  0.10   7.31   8.30   7.31   8.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95929TCC motor evoked lwr limbs                          A   0.00   5.04     5.97     5.04NA   5.97 NA  0.03   5.07   6.00   5.07   6.00  1XXX.00.00.0000000             25.5217 210 99      0.00   0.00   0.00
9592926C motor evoked lwr limbs                          A   1.50   0.67     0.73     0.67     0.73     0.07   2.24   2.30   2.24   2.30  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95930  Visual evoked potential test                      A   0.35   3.56     4.10     3.56NA   4.10 NA  0.02   3.93   4.47   3.93   4.47  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95930TCVisual evoked potential test                      A   0.00   3.40     3.92     3.40NA   3.92 NA  0.01   3.41   3.93   3.41   3.93  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
9593026Visual evoked potential test                      A   0.35   0.16     0.18     0.16     0.18     0.01   0.52   0.54   0.52   0.54  1XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
95933  Blink reflex test                                 A   0.59   1.56     1.79     1.56NA   1.79 NA  0.04   2.19   2.42   2.19   2.42  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95933TCBlink reflex test                                 A   0.00   1.29     1.49     1.29NA   1.49 NA  0.01   1.30   1.50   1.30   1.50  1XXX.00.00.0000000             25.5217 7A0 99      0.00   0.00   0.00
9593326Blink reflex test                                 A   0.59   0.27     0.30     0.27     0.30     0.03   0.89   0.92   0.89   0.92  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95934  H-reflex test                                     A   0.51   1.13     1.31     1.13NA   1.31 NA  0.02   1.66   1.84   1.66   1.84  1XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
95934TCH-reflex test                                     A   0.00   0.89     1.06     0.89NA   1.06 NA  0.01   0.90   1.07   0.90   1.07  1XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
9593426H-reflex test                                     A   0.51   0.24     0.25     0.24     0.25     0.01   0.76   0.77   0.76   0.77  1XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
95936  H-reflex test                                     A   0.55   0.80     0.90     0.80NA   0.90 NA  0.02   1.37   1.47   1.37   1.47  1XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
95936TCH-reflex test                                     A   0.00   0.55     0.63     0.55NA   0.63 NA  0.01   0.56   0.64   0.56   0.64  1XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
9593626H-reflex test                                     A   0.55   0.25     0.27     0.25     0.27     0.01   0.81   0.83   0.81   0.83  1XXX.00.00.0001000             25.5217 090 99      0.00   0.00   0.00
95937  Neuromuscular junction test                       A   0.65   1.20     1.40     1.20NA   1.40 NA  0.05   1.90   2.10   1.90   2.10  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95937TCNeuromuscular junction test                       A   0.00   0.91     1.08     0.91NA   1.08 NA  0.01   0.92   1.09   0.92   1.09  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9593726Neuromuscular junction test                       A   0.65   0.29     0.32     0.29     0.32     0.04   0.98   1.01   0.98   1.01  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95950  Ambulatory eeg monitoring                         A   1.51   6.38     7.13     6.38NA   7.13 NA  0.10   7.99   8.74   7.99   8.74  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95950TCAmbulatory eeg monitoring                         A   0.00   5.71     6.40     5.71NA   6.40 NA  0.03   5.74   6.43   5.74   6.43  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9595026Ambulatory eeg monitoring                         A   1.51   0.67     0.73     0.67     0.73     0.07   2.25   2.31   2.25   2.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95951  EEG monitoring/videorecord                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95951TCEEG monitoring/videorecord                        C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9595126EEG monitoring/videorecord                        A   5.99   2.67     2.91     2.67     2.91     0.48   9.14   9.38   9.14   9.38  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95953  EEG monitoring/computer                           A   3.08   8.93     9.05     8.93NA   9.05 NA  0.18  12.19  12.31  12.19  12.31  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95953TCEEG monitoring/computer                           A   0.00   7.53     7.55     7.53NA   7.55 NA  0.03   7.56   7.58   7.56   7.58  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9595326EEG monitoring/computer                           A   3.08   1.40     1.50     1.40     1.50     0.15   4.63   4.73   4.63   4.73  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95954  EEG monitoring/giving drugs                       A   2.45   6.55     8.00     6.55NA   8.00 NA  0.15   9.15  10.60   9.15  10.60  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95954TCEEG monitoring/giving drugs                       A   0.00   5.76     7.11     5.76NA   7.11 NA  0.04   5.80   7.15   5.80   7.15  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9595426EEG monitoring/giving drugs                       A   2.45   0.79     0.89     0.79     0.89     0.11   3.35   3.45   3.35   3.45  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95955  EEG during surgery                                A   1.01   3.90     4.63     3.90NA   4.63 NA  0.05   4.96   5.69   4.96   5.69  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95955TCEEG during surgery                                A   0.00   3.47     4.15     3.47NA   4.15 NA  0.01   3.48   4.16   3.48   4.16  1XXX.00.00.0000000             25.5217 020 99      0.00   0.00   0.00
9595526EEG during surgery                                A   1.01   0.43     0.48     0.43     0.48     0.04   1.48   1.53   1.48   1.53  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95956  Eeg monitor technol attended                      A   3.61  25.89    32.20    25.89NA  32.20 NA  0.32  29.82  36.13  29.82  36.13  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95956TCEeg monitor technol attended                      A   0.00  24.44    30.54    24.44NA  30.54 NA  0.16  24.60  30.70  24.60  30.70  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9595626Eeg monitor technol attended                      A   3.61   1.45     1.66     1.45     1.66     0.16   5.22   5.43   5.22   5.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95957  EEG digital analysis                              A   1.98   7.92     9.75     7.92NA   9.75 NA  0.11  10.01  11.84  10.01  11.84  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95957TCEEG digital analysis                              A   0.00   7.04     8.80     7.04NA   8.80 NA  0.01   7.05   8.81   7.05   8.81  1XXX.00.00.0000000             25.5217 010 99      0.00   0.00   0.00
9595726EEG digital analysis                              A   1.98   0.88     0.95     0.88     0.95     0.10   2.96   3.03   2.96   3.03  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95958  EEG monitoring/function test                      A   4.24   8.89    10.48     8.89NA  10.48 NA  0.26  13.39  14.98  13.39  14.98  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95958TCEEG monitoring/function test                      A   0.00   7.04     8.51     7.04NA   8.51 NA  0.04   7.08   8.55   7.08   8.55  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9595826EEG monitoring/function test                      A   4.24   1.85     1.97     1.85     1.97     0.22   6.31   6.43   6.31   6.43  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95961  Electrode stimulation brain                       A   2.97   4.29     5.00     4.29NA   5.00 NA  0.15   7.41   8.12   7.41   8.12  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95961TCElectrode stimulation brain                       A   0.00   2.92     3.52     2.92NA   3.52 NA  0.01   2.93   3.53   2.93   3.53  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9596126Electrode stimulation brain                       A   2.97   1.37     1.48     1.37     1.48     0.14   4.48   4.59   4.48   4.59  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95962  Electrode stim brain add-on                       A   3.21   3.31     3.78     3.31NA   3.78 NA  0.15   6.67   7.14   6.67   7.14  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95962TCElectrode stim brain add-on                       A   0.00   1.87     2.20     1.87NA   2.20 NA  0.01   1.88   2.21   1.88   2.21  1ZZZ.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9596226Electrode stim brain add-on                       A   3.21   1.44     1.58     1.44     1.58     0.14   4.79   4.93   4.79   4.93  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95965  Meg spontaneous                                   C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95965TCMeg spontaneous                                   C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9596526Meg spontaneous                                   A   7.99   3.71     3.90     3.71     3.90     0.64  12.34  12.53  12.34  12.53  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95966  Meg evoked single                                 C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95966TCMeg evoked single                                 C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9596626Meg evoked single                                 A   3.99   1.86     1.95     1.86     1.95     0.31   6.16   6.25   6.16   6.25  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95967  Meg evoked each addl                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95967TCMeg evoked each addl                              C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
9596726Meg evoked each addl                              A   3.49   1.56     1.70     1.56     1.70     0.29   5.34   5.48   5.34   5.48  1ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95970  Analyze neurostim no prog                         A   0.45   1.25     1.41     0.19     0.21     0.04   1.74   1.90   0.68   0.70  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95971  Analyze neurostim simple                          A   0.78   0.85     0.82     0.33     0.34     0.07   1.70   1.67   1.18   1.19  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95972  Analyze neurostim complex                         A   1.50   1.49     1.56     0.64     0.70     0.14   3.13   3.20   2.28   2.34  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95973  Analyze neurostim complex                         A   0.92   0.76     0.86     0.39     0.46     0.08   1.76   1.86   1.39   1.46  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95974  Cranial neurostim complex                         A   3.00   2.19     2.50     1.29     1.41     0.26   5.45   5.76   4.55   4.67  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95975  Cranial neurostim complex                         A   1.70   1.12     1.28     0.75     0.83     0.12   2.94   3.10   2.57   2.65  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95978  Analyze neurostim brain/1h                        A   3.50   2.72     3.11     1.56     1.73     0.38   6.60   6.99   5.44   5.61  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95979  Analyz neurostim brain addon                      A   1.64   1.10     1.25     0.74     0.81     0.14   2.88   3.03   2.52   2.59  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95980  Io anal gast n-stim init                          A   0.80   0.37NA   0.44NA   0.37     0.44     0.16   1.33   1.40   1.33   1.40  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95981  Io anal gast n-stim subsq                         A   0.30   0.57     0.60     0.18     0.20     0.03   0.90   0.93   0.51   0.53  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95982  Io ga n-stim subsq w/reprog                       A   0.65   0.71     0.81     0.31     0.36     0.05   1.41   1.51   1.01   1.06  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95990  Spin/brain pump refil & main                      A   0.00   2.20     2.48     2.20NA   2.48 NA  0.03   2.23   2.51   2.23   2.51  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95991  Spin/brain pump refil & main                      A   0.77   2.29     2.64     0.29     0.36     0.05   3.11   3.46   1.11   1.18  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95992  Canalith repositioning proc                       A   0.75   0.45     0.46     0.32     0.33     0.05   1.25   1.26   1.12   1.13  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
95999  Neurological procedure                            C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96000  Motion analysis video/3d                          A   1.80   0.77NA   0.93NA   0.77     0.93     0.11   2.68   2.84   2.68   2.84  7XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
96001  Motion test w/ft press meas                       A   2.15   0.68NA   0.65NA   0.68     0.65     0.12   2.95   2.92   2.95   2.92  7XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
96002  Dynamic surface emg                               A   0.41   0.18NA   0.21NA   0.18     0.21     0.03   0.62   0.65   0.62   0.65  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
96003  Dynamic fine wire emg                             A   0.37   0.15NA   0.18NA   0.15     0.18     0.03   0.55   0.58   0.55   0.58  0XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
96004  Phys review of motion tests                       A   2.14   1.00     1.03     1.00     1.03     0.14   3.28   3.31   3.28   3.31  2XXX.00.00.0002000             25.5217 090 99      0.00   0.00   0.00
96020  Functional brain mapping                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96020TCFunctional brain mapping                          C   0.00   0.00     0.00     0.00NA   0.00 NA  0.00   0.00   0.00   0.00   0.00  1XXX.00.00.0000000             25.5217 030 99      0.00   0.00   0.00
9602026Functional brain mapping                          A   3.43   1.46     1.28     1.46     1.28     0.31   5.20   5.02   5.20   5.02  1XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96040  Genetic counseling 30 min                         B+  0.00   1.29     1.23     1.29NA   1.23 NA  0.03   1.32   1.26   1.32   1.26  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
96101  Psycho testing by psych/phys                      A   1.86   0.51     0.49     0.40     0.29     0.07   2.44   2.42   2.33   2.22  0XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96102  Psycho testing by technician                      A   0.50   1.43     1.74     0.16     0.17     0.03   1.96   2.27   0.69   0.70  0XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96103  Psycho testing admin by comp                      A   0.51   1.12     1.30     0.18     0.19     0.03   1.66   1.84   0.72   0.73  0XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96105  Assessment of aphasia                             A   1.75   1.21     0.17     1.21NA   0.17 NA  0.04   3.00   1.96   3.00   1.96  0XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96110  Developmental test lim                            A   0.00   0.23     0.24     0.23NA   0.24 NA  0.01   0.24   0.25   0.24   0.25  5XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96111  Developmental test extend                         A   2.60   0.93     0.84     0.79     0.67     0.16   3.69   3.60   3.55   3.43  0XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96116  Neurobehavioral status exam                       A   1.86   0.73     0.70     0.56     0.55     0.10   2.69   2.66   2.52   2.51  0XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96118  Neuropsych tst by psych/phys                      A   1.86   0.93     0.69     0.38     0.26     0.07   2.86   2.62   2.31   2.19  0XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96119  Neuropsych testing by tec                         A   0.55   1.51     1.39     0.13     0.09     0.01   2.07   1.95   0.69   0.65  0XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96120  Neuropsych tst admin w/comp                       A   0.51   1.88     2.08     0.17     0.18     0.03   2.42   2.62   0.71   0.72  0XXX.00.00.0000000             25.5217 040 99      0.00   0.00   0.00
96125  Cognitive test by hc pro                          A   1.70   1.00     1.04     1.00NA   1.04 NA  0.07   2.77   2.81   2.77   2.81  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
96150  Assess hlth/behave init                           A   0.50   0.11     0.07     0.10     0.07     0.01   0.62   0.58   0.61   0.58  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96151  Assess hlth/behave subseq                         A   0.48   0.11     0.08     0.10     0.07     0.01   0.60   0.57   0.59   0.56  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96152  Intervene hlth/behave indiv                       A   0.46   0.10     0.07     0.09     0.06     0.01   0.57   0.54   0.56   0.53  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96153  Intervene hlth/behave group                       A   0.10   0.03     0.02     0.02     0.02     0.01   0.14   0.13   0.13   0.13  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96154  Interv hlth/behav fam w/pt                        A   0.45   0.10     0.07     0.09     0.06     0.01   0.56   0.53   0.55   0.52  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96155  Interv hlth/behav fam no pt                       N+  0.44   0.20     0.20     0.19     0.19     0.03   0.67   0.67   0.66   0.66  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
96360  Hydration iv infusion init                        A   0.17   1.48     1.34     1.48NA   1.34 NA  0.03   1.68   1.54   1.68   1.54  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96361  Hydrate iv infusion add-on                        A   0.09   0.36     0.31     0.36NA   0.31 NA  0.01   0.46   0.41   0.46   0.41  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96365  Ther/proph/diag iv inf init                       A   0.21   1.86     1.71     1.86NA   1.71 NA  0.03   2.10   1.95   2.10   1.95  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96366  Ther/proph/diag iv inf addon                      A   0.18   0.45     0.42     0.45NA   0.42 NA  0.01   0.64   0.61   0.64   0.61  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96367  Tx/proph/dg addl seq iv inf                       A   0.19   0.77     0.66     0.77NA   0.66 NA  0.01   0.97   0.86   0.97   0.86  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96368  Ther/diag concurrent inf                          A   0.17   0.40     0.35     0.40NA   0.35 NA  0.01   0.58   0.53   0.58   0.53  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96369  Sc ther infusion up to 1 hr                       A   0.21   4.81     4.84     4.81NA   4.84 NA  0.03   5.05   5.08   5.05   5.08  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96370  Sc ther infusion addl hr                          A   0.18   0.26     0.26     0.26NA   0.26 NA  0.01   0.45   0.45   0.45   0.45  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96371  Sc ther infusion reset pump                       A   0.00   2.35     2.25     2.35NA   2.25 NA  0.01   2.36   2.26   2.36   2.26  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96372  Ther/proph/diag inj sc/im                         A   0.17   0.50     0.50     0.50NA   0.50 NA  0.01   0.68   0.68   0.68   0.68  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96373  Ther/proph/diag inj ia                            A   0.17   0.38     0.38     0.38NA   0.38 NA  0.01   0.56   0.56   0.56   0.56  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96374  Ther/proph/diag inj iv push                       A   0.18   1.44     1.29     1.44NA   1.29 NA  0.03   1.65   1.50   1.65   1.50  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96375  Tx/pro/dx inj new drug addon                      A   0.10   0.56     0.49     0.56NA   0.49 NA  0.01   0.67   0.60   0.67   0.60  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96376  Tx/pro/dx inj same drug adon                      X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
96379  Ther/prop/diag inj/inf proc                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96401  Chemo anti-neopl sq/im                            A   0.21   1.90     1.77     1.90NA   1.77 NA  0.04   2.15   2.02   2.15   2.02  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96402  Chemo hormon antineopl sq/im                      A   0.19   0.84     0.67     0.84NA   0.67 NA  0.01   1.04   0.87   1.04   0.87  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96405  Chemo intralesional up to 7                       A   0.52   1.99     1.79     0.34     0.37     0.03   2.54   2.34   0.89   0.92  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
96406  Chemo intralesional over 7                        A   0.80   2.65     2.36     0.46     0.51     0.04   3.49   3.20   1.30   1.35  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
96409  Chemo iv push sngl drug                           A   0.24   3.04     2.65     3.04NA   2.65 NA  0.05   3.33   2.94   3.33   2.94  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96411  Chemo iv push addl drug                           A   0.20   1.64     1.42     1.64NA   1.42 NA  0.03   1.87   1.65   1.87   1.65  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96413  Chemo iv infusion 1 hr                            A   0.28   4.00     3.44     4.00NA   3.44 NA  0.05   4.33   3.77   4.33   3.77  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96415  Chemo iv infusion addl hr                         A   0.19   0.72     0.62     0.72NA   0.62 NA  0.01   0.92   0.82   0.92   0.82  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96416  Chemo prolong infuse w/pump                       A   0.21   4.49     3.87     4.49NA   3.87 NA  0.07   4.77   4.15   4.77   4.15  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96417  Chemo iv infus each addl seq                      A   0.21   1.90     1.64     1.90NA   1.64 NA  0.03   2.14   1.88   2.14   1.88  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96420  Chemo ia push tecnique                            A   0.17   2.97     2.58     2.97NA   2.58 NA  0.08   3.22   2.83   3.22   2.83  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96422  Chemo ia infusion up to 1 hr                      A   0.17   4.93     4.27     4.93NA   4.27 NA  0.08   5.18   4.52   5.18   4.52  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96423  Chemo ia infuse each addl hr                      A   0.17   2.15     1.89     2.15NA   1.89 NA  0.04   2.36   2.10   2.36   2.10  5ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96425  Chemotherapy infusion method                      A   0.17   5.04     4.57     5.04NA   4.57 NA  0.10   5.31   4.84   5.31   4.84  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96440  Chemotherapy intracavitary                        A   2.37  18.62    19.93     1.45     1.51     0.54  21.53  22.84   4.36   4.42  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96446  Chemotx admn prtl cavity                          A   0.37   4.79     4.79     0.19     0.19     0.07   5.23   5.23   0.63   0.63  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96450  Chemotherapy into cns                             A   1.53   4.23     3.38     0.88     0.76     0.11   5.87   5.02   2.52   2.40  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96521  Refill/maint portable pump                        A   0.21   3.67     3.36     3.67NA   3.36 NA  0.05   3.93   3.62   3.93   3.62  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96522  Refill/maint pump/resvr syst                      A   0.21   3.02     2.71     3.02NA   2.71 NA  0.05   3.28   2.97   3.28   2.97  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96523  Irrig drug delivery device                        T   0.04   0.70     0.61     0.70NA   0.61 NA  0.01   0.75   0.66   0.75   0.66  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96542  Chemotherapy injection                            A   0.75   2.96     2.38     0.50     0.46     0.04   3.75   3.17   1.29   1.25  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96549  Chemotherapy unspecified                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96567  Photodynamic tx skin                              A   0.00   3.86     3.78     3.86NA   3.78 NA  0.01   3.87   3.79   3.87   3.79  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96570  Photodynmc tx 30 min add-on                       A   1.10   0.47     0.44     0.47     0.44     0.18   1.75   1.72   1.75   1.72  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
96571  Photodynamic tx addl 15 min                       A   0.55   0.21     0.19     0.21     0.19     0.04   0.80   0.78   0.80   0.78  0ZZZ.00.00.0000100             25.5217 090 99      0.00   0.00   0.00
96900  Ultraviolet light therapy                         A   0.00   0.60     0.57     0.60NA   0.57 NA  0.01   0.61   0.58   0.61   0.58  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96902  Trichogram                                        B+  0.41   0.20     0.20     0.18     0.18     0.03   0.64   0.64   0.62   0.62  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
96904  Whole body photography                            R   0.00   2.00     1.82     2.00NA   1.82 NA  0.01   2.01   1.83   2.01   1.83  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96910  Photochemotherapy with UV-B                       A   0.00   2.04     1.99     2.04NA   1.99 NA  0.01   2.05   2.00   2.05   2.00  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96912  Photochemotherapy with UV-A                       A   0.00   2.62     2.56     2.62NA   2.56 NA  0.01   2.63   2.57   2.63   2.57  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96913  Photochemotherapy uv-a or b                       A   0.00   3.65     3.61     3.65NA   3.61 NA  0.01   3.66   3.62   3.66   3.62  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
96920  Laser tx skin < 250 sq cm                         A   1.15   3.92     3.83     0.79     0.85     0.04   5.11   5.02   1.98   2.04  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
96921  Laser tx skin 250-500 sq cm                       A   1.17   3.91     3.95     0.77     0.85     0.04   5.12   5.16   1.98   2.06  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
96922  Laser tx skin > 500 sq cm                         A   2.10   5.19     5.09     1.39     1.56     0.08   7.37   7.27   3.57   3.74  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
96999  Dermatological procedure                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97001  Pt evaluation                                     A   1.20   0.89     0.92     0.89NA   0.92 NA  0.05   2.14   2.17   2.14   2.17  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97002  Pt re-evaluation                                  A   0.60   0.55     0.58     0.55NA   0.58 NA  0.03   1.18   1.21   1.18   1.21  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97003  Ot evaluation                                     A   1.20   1.11     1.23     1.11NA   1.23 NA  0.05   2.36   2.48   2.36   2.48  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97004  Ot re-evaluation                                  A   0.60   0.80     0.90     0.80NA   0.90 NA  0.03   1.43   1.53   1.43   1.53  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97005  Athletic train eval                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
97006  Athletic train reeval                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
97010  Hot or cold packs therapy                         B+  0.06   0.09     0.10     0.09NA   0.10 NA  0.01   0.16   0.17   0.16   0.17  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
97012  Mechanical traction therapy                       A   0.25   0.19     0.20     0.19NA   0.20 NA  0.01   0.45   0.46   0.45   0.46  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97014  Electric stimulation therapy                      I+  0.18   0.24     0.27     0.24NA   0.27 NA  0.01   0.43   0.46   0.43   0.46  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
97016  Vasopneumatic device therapy                      A   0.18   0.32     0.35     0.32NA   0.35 NA  0.01   0.51   0.54   0.51   0.54  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97018  Paraffin bath therapy                             A   0.06   0.21     0.23     0.21NA   0.23 NA  0.01   0.28   0.30   0.28   0.30  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97022  Whirlpool therapy                                 A   0.17   0.42     0.47     0.42NA   0.47 NA  0.01   0.60   0.65   0.60   0.65  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97024  Diathermy eg microwave                            A   0.06   0.11     0.12     0.11NA   0.12 NA  0.01   0.18   0.19   0.18   0.19  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97026  Infrared therapy                                  R   0.06   0.09     0.10     0.09NA   0.10 NA  0.01   0.16   0.17   0.16   0.17  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97028  Ultraviolet therapy                               A   0.08   0.11     0.12     0.11NA   0.12 NA  0.01   0.20   0.21   0.20   0.21  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97032  Electrical stimulation                            A   0.25   0.26     0.28     0.26NA   0.28 NA  0.01   0.52   0.54   0.52   0.54  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97033  Electric current therapy                          A   0.26   0.56     0.64     0.56NA   0.64 NA  0.01   0.83   0.91   0.83   0.91  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97034  Contrast bath therapy                             A   0.21   0.26     0.29     0.26NA   0.29 NA  0.01   0.48   0.51   0.48   0.51  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97035  Ultrasound therapy                                A   0.21   0.13     0.14     0.13NA   0.14 NA  0.01   0.35   0.36   0.35   0.36  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97036  Hydrotherapy                                      A   0.28   0.57     0.63     0.57NA   0.63 NA  0.01   0.86   0.92   0.86   0.92  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97039  Physical therapy treatment                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  7XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97110  Therapeutic exercises                             A   0.45   0.42     0.45     0.42NA   0.45 NA  0.01   0.88   0.91   0.88   0.91  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97112  Neuromuscular reeducation                         A   0.45   0.45     0.49     0.45NA   0.49 NA  0.01   0.91   0.95   0.91   0.95  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97113  Aquatic therapy/exercises                         A   0.44   0.69     0.76     0.69NA   0.76 NA  0.01   1.14   1.21   1.14   1.21  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97116  Gait training therapy                             A   0.40   0.36     0.39     0.36NA   0.39 NA  0.01   0.77   0.80   0.77   0.80  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97124  Massage therapy                                   A   0.35   0.35     0.38     0.35NA   0.38 NA  0.01   0.71   0.74   0.71   0.74  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97139  Physical medicine procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  7XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97140  Manual therapy                                    A   0.43   0.38     0.41     0.38NA   0.41 NA  0.01   0.82   0.85   0.82   0.85  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97150  Group therapeutic procedures                      A   0.27   0.28     0.31     0.28NA   0.31 NA  0.01   0.56   0.59   0.56   0.59  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97530  Therapeutic activities                            A   0.44   0.50     0.54     0.50NA   0.54 NA  0.01   0.95   0.99   0.95   0.99  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97532  Cognitive skills development                      A   0.44   0.29     0.31     0.29NA   0.31 NA  0.01   0.74   0.76   0.74   0.76  7XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97533  Sensory integration                               A   0.44   0.36     0.38     0.36NA   0.38 NA  0.01   0.81   0.83   0.81   0.83  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97535  Self care mngment training                        A   0.45   0.49     0.53     0.49NA   0.53 NA  0.01   0.95   0.99   0.95   0.99  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97537  Community/work reintegration                      A   0.45   0.37     0.40     0.37NA   0.40 NA  0.01   0.83   0.86   0.83   0.86  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97542  Wheelchair mngment training                       A   0.45   0.38     0.41     0.38NA   0.41 NA  0.01   0.84   0.87   0.84   0.87  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97545  Work hardening                                    R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  7XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97546  Work hardening add-on                             R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  7ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97597  Rmvl devital tis 20 cm/<                          A   0.51   1.56     1.56     0.15     0.15     0.05   2.12   2.12   0.71   0.71  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97598  Rmvl devital tis addl 20 cm<                      A   0.24   0.44     0.44     0.07     0.07     0.03   0.71   0.71   0.34   0.34  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97602  Wound(s) care non-selective                       B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
97605  Neg press wound tx < 50 cm                        A   0.55   0.53     0.58     0.17     0.16     0.08   1.16   1.21   0.80   0.79  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97606  Neg press wound tx > 50 cm                        A   0.60   0.54     0.59     0.18     0.17     0.10   1.24   1.29   0.88   0.87  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97750  Physical performance test                         A   0.45   0.44     0.47     0.44NA   0.47 NA  0.03   0.92   0.95   0.92   0.95  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97755  Assistive technology assess                       A   0.62   0.37     0.39     0.37NA   0.39 NA  0.03   1.02   1.04   1.02   1.04  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97760  Orthotic mgmt and training                        A   0.45   0.56     0.61     0.56NA   0.61 NA  0.03   1.04   1.09   1.04   1.09  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97761  Prosthetic training                               A   0.45   0.43     0.47     0.43NA   0.47 NA  0.03   0.91   0.95   0.91   0.95  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97762  C/o for orthotic/prosth use                       A   0.25   0.93     1.06     0.93NA   1.06 NA  0.01   1.19   1.32   1.19   1.32  7XXX.00.00.0050000             25.5217 090 99      0.00   0.00   0.00
97799  Physical medicine procedure                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  7XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97802  Medical nutrition indiv in                        A   0.53   0.38     0.42     0.32     0.36     0.03   0.94   0.98   0.88   0.92  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97803  Med nutrition indiv subseq                        A   0.45   0.34     0.37     0.28     0.31     0.03   0.82   0.85   0.76   0.79  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97804  Medical nutrition group                           A   0.25   0.15     0.18     0.15     0.17     0.01   0.41   0.44   0.41   0.43  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
97810  Acupunct w/o stimul 15 min                        N+  0.60   0.42     0.41     0.26     0.26     0.04   1.06   1.05   0.90   0.90  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
97811  Acupunct w/o stimul addl 15m                      N+  0.50   0.27     0.27     0.21     0.22     0.03   0.80   0.80   0.74   0.75  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
97813  Acupunct w/stimul 15 min                          N+  0.65   0.44     0.44     0.28     0.29     0.04   1.13   1.13   0.97   0.98  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
97814  Acupunct w/stimul addl 15m                        N+  0.55   0.32     0.32     0.24     0.24     0.04   0.91   0.91   0.83   0.83  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
98925  Osteopathic manipulation                          A   0.45   0.41     0.44     0.18     0.21     0.03   0.89   0.92   0.66   0.69  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
98926  Osteopathic manipulation                          A   0.65   0.52     0.56     0.26     0.28     0.03   1.20   1.24   0.94   0.96  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
98927  Osteopathic manipulation                          A   0.87   0.64     0.71     0.33     0.35     0.04   1.55   1.62   1.24   1.26  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
98928  Osteopathic manipulation                          A   1.03   0.73     0.79     0.39     0.41     0.05   1.81   1.87   1.47   1.49  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
98929  Osteopathic manipulation                          A   1.19   0.84     0.92     0.45     0.48     0.07   2.10   2.18   1.71   1.74  0000.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
98940  Chiropractic manipulation                         A   0.45   0.29     0.30     0.15     0.16     0.01   0.75   0.76   0.61   0.62  0000.00.00.0000000             25.5217 093 99      0.00   0.00   0.00
98941  Chiropractic manipulation                         A   0.65   0.37     0.39     0.23     0.23     0.03   1.05   1.07   0.91   0.91  0000.00.00.0000000             25.5217 093 99      0.00   0.00   0.00
98942  Chiropractic manipulation                         A   0.87   0.44     0.47     0.30     0.31     0.03   1.34   1.37   1.20   1.21  0000.00.00.0000000             25.5217 093 99      0.00   0.00   0.00
98943  Chiropractic manipulation                         N+  0.40   0.28     0.28     0.17     0.18     0.03   0.71   0.71   0.60   0.61  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
98960  Self-mgmt educ & train 1 pt                       B+  0.00   0.76     0.73     0.76NA   0.73 NA  0.01   0.77   0.74   0.77   0.74  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
98961  Self-mgmt educ/train 2-4 pt                       B+  0.00   0.37     0.35     0.37NA   0.35 NA  0.01   0.38   0.36   0.38   0.36  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
98962  Self-mgmt educ/train 5-8 pt                       B+  0.00   0.27     0.25     0.27NA   0.25 NA  0.01   0.28   0.26   0.28   0.26  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
98966  Hc pro phone call 5-10 min                        N+  0.25   0.15     0.15     0.10     0.11     0.01   0.41   0.41   0.36   0.37  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
98967  Hc pro phone call 11-20 min                       N+  0.50   0.25     0.26     0.21     0.22     0.03   0.78   0.79   0.74   0.75  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
98968  Hc pro phone call 21-30 min                       N+  0.75   0.36     0.37     0.32     0.33     0.05   1.16   1.17   1.12   1.13  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
98969  Online service by hc pro                          N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99000  Specimen handling                                 B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99001  Specimen handling                                 B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99002  Device handling                                   B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99024  Postop follow-up visit                            B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99026  In-hospital on call service                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99027  Out-of-hosp on call service                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99050  Medical services after hrs                        B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99051  Med serv eve/wkend/holiday                        B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99053  Med serv 10pm-8am 24 hr fac                       B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99056  Med service out of office                         B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99058  Office emergency care                             B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99060  Out of office emerg med serv                      B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99070  Special supplies                                  B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99071  Patient education materials                       B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99075  Medical testimony                                 N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99078  Group health education                            B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99080  Special reports or forms                          B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99082  Unusual physician travel                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99090  Computer data analysis                            B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99091  Collect/review data from pt                       B+  1.10   0.47     0.48     0.47NA   0.48 NA  0.07   1.64   1.65   1.64   1.65  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99100  Special anesthesia service                        B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99116  Anesthesia with hypothermia                       B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99135  Special anesthesia procedure                      B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99140  Emergency anesthesia                              B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99143  Mod cs by same phys < 5 yrs                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99144  Mod cs by same phys 5 yrs +                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99145  Mod cs by same phys add-on                        C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99148  Mod cs diff phys < 5 yrs                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99149  Mod cs diff phys 5 yrs +                          C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99150  Mod cs diff phys add-on                           C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99170  Anogenital exam child                             A   1.75   2.39     2.19     0.91     0.86     0.12   4.26   4.06   2.78   2.73  0000.00.00.0020100             25.5217 090 99      0.00   0.00   0.00
99172  Ocular function screen                            N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99173  Visual acuity screen                              N+  0.00   0.07     0.07     0.07NA   0.07 NA  0.01   0.08   0.08   0.08   0.08  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99174  Ocular photoscreening                             N+  0.00   0.81     0.78     0.81NA   0.78 NA  0.01   0.82   0.79   0.82   0.79  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99175  Induction of vomiting                             A   0.00   0.71     0.66     0.71NA   0.66 NA  0.01   0.72   0.67   0.72   0.67  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99183  Hyperbaric oxygen therapy                         A   2.34   3.54     3.69     0.89     0.99     0.26   6.14   6.29   3.49   3.59  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99190  Special pump services                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99191  Special pump services                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99192  Special pump services                             X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99195  Phlebotomy                                        A   0.00   2.50     2.62     2.50NA   2.62 NA  0.05   2.55   2.67   2.55   2.67  5XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99199  Special service/proc/report                       C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99201  Office/outpatient visit new                       A   0.48   0.70     0.73     0.24     0.26     0.04   1.22   1.25   0.76   0.78  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99202  Office/outpatient visit new                       A   0.93   1.09     1.16     0.44     0.49     0.07   2.09   2.16   1.44   1.49  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99203  Office/outpatient visit new                       A   1.42   1.48     1.57     0.64     0.72     0.14   3.04   3.13   2.20   2.28  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99204  Office/outpatient visit new                       A   2.43   2.01     2.15     1.06     1.21     0.23   4.67   4.81   3.72   3.87  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99205  Office/outpatient visit new                       A   3.17   2.37     2.52     1.34     1.50     0.27   5.81   5.96   4.78   4.94  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99211  Office/outpatient visit est                       A   0.18   0.39     0.37     0.08     0.08     0.01   0.58   0.56   0.27   0.27  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99212  Office/outpatient visit est                       A   0.48   0.70     0.73     0.22     0.24     0.04   1.22   1.25   0.74   0.76  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99213  Office/outpatient visit est                       A   0.97   0.99     1.06     0.42     0.47     0.07   2.03   2.10   1.46   1.51  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99214  Office/outpatient visit est                       A   1.50   1.42     1.49     0.63     0.71     0.10   3.02   3.09   2.23   2.31  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99215  Office/outpatient visit est                       A   2.11   1.81     1.91     0.90     1.00     0.14   4.06   4.16   3.15   3.25  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99217  Observation care discharge                        A   1.28   0.68NA   0.73NA   0.68     0.73     0.08   2.04   2.09   2.04   2.09  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99218  Initial observation caree                         A   1.28   0.54NA   0.58NA   0.54     0.58     0.08   1.90   1.94   1.90   1.94  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99219  Initial observation care                          A   2.14   0.89NA   0.98NA   0.89     0.98     0.14   3.17   3.26   3.17   3.26  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99220  Initial observation care                          A   2.99   1.24NA   1.35NA   1.24     1.35     0.20   4.43   4.54   4.43   4.54  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99221  Initial hospital care                             A   1.92   0.76NA   0.86NA   0.76     0.86     0.18   2.86   2.96   2.86   2.96  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99222  Initial hospital care                             A   2.61   1.06NA   1.21NA   1.06     1.21     0.22   3.89   4.04   3.89   4.04  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99223  Initial hospital care                             A   3.86   1.56NA   1.78NA   1.56     1.78     0.29   5.71   5.93   5.71   5.93  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99224  Subsequent observation care                       A   0.54   0.24NA   0.24NA   0.24     0.24     0.04   0.82   0.82   0.82   0.82  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99225  Subsequent observation care                       A   0.96   0.44NA   0.44NA   0.44     0.44     0.05   1.45   1.45   1.45   1.45  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99226  Subsequent observation care                       A   1.44   0.65NA   0.65NA   0.65     0.65     0.08   2.17   2.17   2.17   2.17  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99231  Subsequent hospital care                          A   0.76   0.32NA   0.34NA   0.32     0.34     0.05   1.13   1.15   1.13   1.15  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99232  Subsequent hospital care                          A   1.39   0.58NA   0.64NA   0.58     0.64     0.08   2.05   2.11   2.05   2.11  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99233  Subsequent hospital care                          A   2.00   0.82NA   0.90NA   0.82     0.90     0.12   2.94   3.02   2.94   3.02  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99234  Observ/hosp same date                             A   2.56   1.10NA   1.16NA   1.10     1.16     0.22   3.88   3.94   3.88   3.94  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99235  Observ/hosp same date                             A   3.41   1.43NA   1.56NA   1.43     1.56     0.23   5.07   5.20   5.07   5.20  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99236  Observ/hosp same date                             A   4.26   1.75NA   1.90NA   1.75     1.90     0.29   6.30   6.45   6.30   6.45  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99238  Hospital discharge day                            A   1.28   0.69NA   0.74NA   0.69     0.74     0.07   2.04   2.09   2.04   2.09  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99239  Hospital discharge day                            A   1.90   0.98NA   1.09NA   0.98     1.09     0.11   2.99   3.10   2.99   3.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99241  Office consultation                               I+  0.64   0.66     0.66     0.24     0.24     0.07   1.37   1.37   0.95   0.95  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99242  Office consultation                               I+  1.34   1.10     1.10     0.51     0.51     0.14   2.58   2.58   1.99   1.99  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99243  Office consultation                               I+  1.88   1.46     1.46     0.71     0.71     0.18   3.52   3.52   2.77   2.77  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99244  Office consultation                               I+  3.02   1.96     1.96     1.14     1.14     0.22   5.20   5.20   4.38   4.38  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99245  Office consultation                               I+  3.77   2.30     2.30     1.38     1.38     0.29   6.36   6.36   5.44   5.44  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99251  Inpatient consultation                            I+  1.00   0.32NA   0.32NA   0.32     0.32     0.07   1.39   1.39   1.39   1.39  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99252  Inpatient consultation                            I+  1.50   0.52NA   0.52NA   0.52     0.52     0.12   2.14   2.14   2.14   2.14  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99253  Inpatient consultation                            I+  2.27   0.84NA   0.84NA   0.84     0.84     0.15   3.26   3.26   3.26   3.26  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99254  Inpatient consultation                            I+  3.29   1.23NA   1.23NA   1.23     1.23     0.18   4.70   4.70   4.70   4.70  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99255  Inpatient consultation                            I+  4.00   1.44NA   1.44NA   1.44     1.44     0.24   5.68   5.68   5.68   5.68  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99281  Emergency dept visit                              A   0.45   0.13NA   0.15NA   0.13     0.15     0.03   0.61   0.63   0.61   0.63  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99282  Emergency dept visit                              A   0.88   0.24NA   0.27NA   0.24     0.27     0.07   1.19   1.22   1.19   1.22  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99283  Emergency dept visit                              A   1.34   0.36NA   0.39NA   0.36     0.39     0.10   1.80   1.83   1.80   1.83  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99284  Emergency dept visit                              A   2.56   0.62NA   0.67NA   0.62     0.67     0.22   3.40   3.45   3.40   3.45  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99285  Emergency dept visit                              A   3.80   0.88NA   0.91NA   0.88     0.91     0.30   4.98   5.01   4.98   5.01  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99288  Direct advanced life support                      B   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99291  Critical care first hour                          A   4.50   2.95     3.04     1.56     1.68     0.34   7.79   7.88   6.40   6.52  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99292  Critical care addl 30 min                         A   2.25   1.07     1.13     0.78     0.84     0.18   3.50   3.56   3.21   3.27  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99304  Nursing facility care init                        A   1.64   0.82     0.94     0.82     0.94     0.14   2.60   2.72   2.60   2.72  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99305  Nursing facility care init                        A   2.35   1.09     1.28     1.09     1.28     0.20   3.64   3.83   3.64   3.83  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99306  Nursing facility care init                        A   3.06   1.34     1.59     1.34     1.59     0.23   4.63   4.88   4.63   4.88  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99307  Nursing fac care subseq                           A   0.76   0.44     0.49     0.44     0.49     0.04   1.24   1.29   1.24   1.29  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99308  Nursing fac care subseq                           A   1.16   0.68     0.77     0.68     0.77     0.07   1.91   2.00   1.91   2.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99309  Nursing fac care subseq                           A   1.55   0.88     1.00     0.88     1.00     0.08   2.51   2.63   2.51   2.63  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99310  Nursing fac care subseq                           A   2.35   1.24     1.41     1.24     1.41     0.14   3.73   3.90   3.73   3.90  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99315  Nursing fac discharge day                         A   1.13   0.61     0.70     0.61     0.70     0.07   1.81   1.90   1.81   1.90  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99316  Nursing fac discharge day                         A   1.50   0.77     0.87     0.77     0.87     0.08   2.35   2.45   2.35   2.45  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99318  Annual nursing fac assessmnt                      A   1.71   0.84     0.99     0.84     0.99     0.10   2.65   2.80   2.65   2.80  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99324  Domicil/r-home visit new pat                      A   1.01   0.54     0.55     0.54NA   0.55 NA  0.07   1.62   1.63   1.62   1.63  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99325  Domicil/r-home visit new pat                      A   1.52   0.73     0.73     0.73NA   0.73 NA  0.10   2.35   2.35   2.35   2.35  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99326  Domicil/r-home visit new pat                      A   2.63   1.19     1.31     1.19NA   1.31 NA  0.16   3.98   4.10   3.98   4.10  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99327  Domicil/r-home visit new pat                      A   3.46   1.55     1.74     1.55NA   1.74 NA  0.22   5.23   5.42   5.23   5.42  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99328  Domicil/r-home visit new pat                      A   4.09   1.78     2.00     1.78NA   2.00 NA  0.24   6.11   6.33   6.11   6.33  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99334  Domicil/r-home visit est pat                      A   1.07   0.58     0.62     0.58NA   0.62 NA  0.07   1.72   1.76   1.72   1.76  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99335  Domicil/r-home visit est pat                      A   1.72   0.84     0.94     0.84NA   0.94 NA  0.10   2.66   2.76   2.66   2.76  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99336  Domicil/r-home visit est pat                      A   2.46   1.15     1.32     1.15NA   1.32 NA  0.14   3.75   3.92   3.75   3.92  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99337  Domicil/r-home visit est pat                      A   3.58   1.60     1.83     1.60NA   1.83 NA  0.23   5.41   5.64   5.41   5.64  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99339  Domicil/r-home care supervis                      B+  1.25   0.91     0.92     0.91NA   0.92 NA  0.08   2.24   2.25   2.24   2.25  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99340  Domicil/r-home care supervis                      B+  1.80   1.22     1.23     1.22NA   1.23 NA  0.12   3.14   3.15   3.14   3.15  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99341  Home visit new patient                            A   1.01   0.53     0.52     0.53NA   0.52 NA  0.07   1.61   1.60   1.61   1.60  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99342  Home visit new patient                            A   1.52   0.71     0.70     0.71NA   0.70 NA  0.11   2.34   2.33   2.34   2.33  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99343  Home visit new patient                            A   2.53   1.11     1.15     1.11NA   1.15 NA  0.18   3.82   3.86   3.82   3.86  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99344  Home visit new patient                            A   3.38   1.54     1.75     1.54NA   1.75 NA  0.22   5.14   5.35   5.14   5.35  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99345  Home visit new patient                            A   4.09   1.81     2.06     1.81NA   2.06 NA  0.26   6.16   6.41   6.16   6.41  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99347  Home visit est patient                            A   1.00   0.53     0.55     0.53NA   0.55 NA  0.07   1.60   1.62   1.60   1.62  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99348  Home visit est patient                            A   1.56   0.76     0.80     0.76NA   0.80 NA  0.10   2.42   2.46   2.42   2.46  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99349  Home visit est patient                            A   2.33   1.11     1.27     1.11NA   1.27 NA  0.14   3.58   3.74   3.58   3.74  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99350  Home visit est patient                            A   3.28   1.50     1.70     1.50NA   1.70 NA  0.22   5.00   5.20   5.00   5.20  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99354  Prolonged service office                          A   1.77   0.93     1.01     0.75     0.82     0.11   2.81   2.89   2.63   2.70  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99355  Prolonged service office                          A   1.77   0.90     0.96     0.72     0.78     0.11   2.78   2.84   2.60   2.66  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99356  Prolonged service inpatient                       A   1.71   0.76NA   0.85NA   0.76     0.85     0.11   2.58   2.67   2.58   2.67  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99357  Prolonged service inpatient                       A   1.71   0.76NA   0.85NA   0.76     0.85     0.11   2.58   2.67   2.58   2.67  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99358  Prolong service w/o contact                       B+  2.10   0.94     0.96     0.94     0.96     0.14   3.18   3.20   3.18   3.20  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99359  Prolong serv w/o contact add                      B+  1.00   0.47     0.48     0.47     0.48     0.07   1.54   1.55   1.54   1.55  9ZZZ.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99360  Physician standby services                        X+  1.20   0.51NA   0.53NA   0.51     0.53     0.08   1.79   1.81   1.79   1.81  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99363  Anticoag mgmt init                                B+  1.65   1.89     1.87     0.70     0.73     0.11   3.65   3.63   2.46   2.49  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99364  Anticoag mgmt subseq                              B+  0.63   0.57     0.57     0.27     0.28     0.04   1.24   1.24   0.94   0.95  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99366  Team conf w/pat by hc pro                         B+  0.82   0.37     0.38     0.35     0.36     0.05   1.24   1.25   1.22   1.23  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99367  Team conf w/o pat by phys                         B+  1.10   0.47NA   0.48NA   0.47     0.48     0.07   1.64   1.65   1.64   1.65  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99368  Team conf w/o pat by hc pro                       B+  0.72   0.31NA   0.32NA   0.31     0.32     0.04   1.07   1.08   1.07   1.08  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99374  Home health care supervision                      B+  1.10   0.85     0.85     0.48     0.48     0.07   2.02   2.02   1.65   1.65  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99375  Home health care supervision                      I+  1.73   1.28     1.20     0.88     0.76     0.11   3.12   3.04   2.72   2.60  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99377  Hospice care supervision                          B+  1.10   0.85     0.85     0.48     0.48     0.07   2.02   2.02   1.65   1.65  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99378  Hospice care supervision                          I+  1.73   1.34     1.20     0.94     0.76     0.11   3.18   3.04   2.78   2.60  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99379  Nursing fac care supervision                      B+  1.10   0.85     0.85     0.48     0.48     0.07   2.02   2.02   1.65   1.65  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99380  Nursing fac care supervision                      B+  1.73   1.20     1.20     0.75     0.76     0.11   3.04   3.04   2.59   2.60  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99381  Init pm e/m new pat inf                           N+  1.19   1.49     1.43     0.51     0.52     0.08   2.76   2.70   1.78   1.79  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99382  Init pm e/m new pat 1-4 yrs                       N+  1.36   1.56     1.50     0.59     0.60     0.08   3.00   2.94   2.03   2.04  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99383  Prev visit new age 5-11                           N+  1.36   1.54     1.49     0.59     0.60     0.08   2.98   2.93   2.03   2.04  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99384  Prev visit new age 12-17                          N+  1.53   1.62     1.56     0.66     0.67     0.10   3.25   3.19   2.29   2.30  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99385  Prev visit new age 18-39                          N+  1.53   1.62     1.56     0.66     0.67     0.10   3.25   3.19   2.29   2.30  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99386  Prev visit new age 40-64                          N+  1.88   1.78     1.72     0.81     0.83     0.12   3.78   3.72   2.81   2.83  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99387  Init pm e/m new pat 65+ yrs                       N+  2.06   1.97     1.91     0.90     0.91     0.14   4.17   4.11   3.10   3.11  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99391  Per pm reeval est pat inf                         N+  1.02   1.25     1.23     0.44     0.45     0.07   2.34   2.32   1.53   1.54  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99392  Prev visit est age 1-4                            N+  1.19   1.32     1.30     0.51     0.52     0.08   2.59   2.57   1.78   1.79  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99393  Prev visit est age 5-11                           N+  1.19   1.31     1.30     0.51     0.52     0.08   2.58   2.57   1.78   1.79  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99394  Prev visit est age 12-17                          N+  1.36   1.39     1.37     0.59     0.60     0.08   2.83   2.81   2.03   2.04  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99395  Prev visit est age 18-39                          N+  1.36   1.39     1.38     0.59     0.60     0.08   2.83   2.82   2.03   2.04  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99396  Prev visit est age 40-64                          N+  1.53   1.47     1.45     0.66     0.67     0.10   3.10   3.08   2.29   2.30  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99397  Per pm reeval est pat 65+ yr                      N+  1.71   1.67     1.65     0.75     0.75     0.11   3.49   3.47   2.57   2.57  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99401  Preventive counseling indiv                       N+  0.48   0.56     0.52     0.21     0.21     0.03   1.07   1.03   0.72   0.72  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99402  Preventive counseling indiv                       N+  0.98   0.78     0.74     0.42     0.43     0.07   1.83   1.79   1.47   1.48  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99403  Preventive counseling indiv                       N+  1.46   1.00     0.95     0.63     0.64     0.10   2.56   2.51   2.19   2.20  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99404  Preventive counseling indiv                       N+  1.95   1.22     1.17     0.85     0.86     0.12   3.29   3.24   2.92   2.93  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99406  Behav chng smoking 3-10 min                       A   0.24   0.15     0.16     0.10     0.10     0.01   0.40   0.41   0.35   0.35  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99407  Behav chng smoking > 10 min                       A   0.50   0.25     0.27     0.20     0.22     0.03   0.78   0.80   0.73   0.75  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99408  Audit/dast 15-30 min                              N+  0.65   0.33     0.34     0.28     0.29     0.04   1.02   1.03   0.97   0.98  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99409  Audit/dast over 30 min                            N+  1.30   0.61     0.62     0.56     0.57     0.08   1.99   2.00   1.94   1.95  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99411  Preventive counseling group                       N+  0.15   0.30     0.30     0.06     0.07     0.01   0.46   0.46   0.22   0.23  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99412  Preventive counseling group                       N+  0.25   0.34     0.34     0.11     0.11     0.01   0.60   0.60   0.37   0.37  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99420  Health risk assessment test                       N+  0.00   0.29     0.28     0.29NA   0.28 NA  0.01   0.30   0.29   0.30   0.29  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99429  Unlisted preventive service                       N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99441  Phone e/m by phys 5-10 min                        N+  0.25   0.15     0.15     0.10     0.11     0.01   0.41   0.41   0.36   0.37  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99442  Phone e/m by phys 11-20 min                       N+  0.50   0.25     0.26     0.21     0.22     0.03   0.78   0.79   0.74   0.75  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99443  Phone e/m by phys 21-30 min                       N+  0.75   0.36     0.37     0.32     0.33     0.05   1.16   1.17   1.12   1.13  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99444  Online e/m by phys                                N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99450  Basic life disability exam                        N   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99455  Work related disability exam                      R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99456  Disability examination                            R   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99460  Init nb em per day hosp                           A   1.17   0.48NA   0.55NA   0.48     0.55     0.05   1.70   1.77   1.70   1.77  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99461  Init nb em per day non-fac                        A   1.26   1.35     1.45     0.54     0.55     0.08   2.69   2.79   1.88   1.89  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99462  Sbsq nb em per day hosp                           A   0.62   0.26NA   0.29NA   0.26     0.29     0.04   0.92   0.95   0.92   0.95  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99463  Same day nb discharge                             A   1.50   0.76NA   0.86NA   0.76     0.86     0.08   2.34   2.44   2.34   2.44  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99464  Attendance at delivery                            A   1.50   0.54NA   0.60NA   0.54     0.60     0.07   2.11   2.17   2.11   2.17  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99465  Nb resuscitation                                  A   2.93   0.93NA   0.68NA   0.93     0.68     0.22   4.08   3.83   4.08   3.83  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99466  Ped crit care transport                           A   4.79   1.99NA   2.24NA   1.99     2.24     1.02   7.80   8.05   7.80   8.05  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99467  Ped crit care transport addl                      A   2.40   0.95NA   1.06NA   0.95     1.06     0.14   3.49   3.60   3.49   3.60  0ZZZ.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99468  Neonate crit care initial                         A  18.46   6.50NA   7.42NA   6.50     7.42     1.52  26.48  27.40  26.48  27.40  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99469  Neonate crit care subsq                           A   7.99   3.12NA   3.52NA   3.12     3.52     0.42  11.53  11.93  11.53  11.93  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99471  Ped critical care initial                         A  15.98   5.97NA   6.42NA   5.97     6.42     0.87  22.82  23.27  22.82  23.27  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99472  Ped critical care subsq                           A   7.99   3.01NA   3.29NA   3.01     3.29     0.48  11.48  11.76  11.48  11.76  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99475  Ped crit care age 2-5 init                        A  11.25   4.01     4.53     4.01     4.53     0.86  16.12  16.64  16.12  16.64  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99476  Ped crit care age 2-5 subsq                       A   6.75   2.50     2.90     2.50     2.90     0.52   9.77  10.17   9.77  10.17  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99477  Init day hosp neonate care                        A   7.00   2.81NA   3.08NA   2.81     3.08     0.38  10.19  10.46  10.19  10.46  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99478  Ic lbw inf < 1500 gm subsq                        A   2.75   1.11NA   1.11NA   1.11     1.11     0.18   4.04   4.04   4.04   4.04  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99479  Ic lbw inf 1500-2500 g subsq                      A   2.50   1.05NA   1.22NA   1.05     1.22     0.16   3.71   3.88   3.71   3.88  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99480  Ic inf pbw 2501-5000 g subsq                      A   2.40   0.91NA   0.96NA   0.91     0.96     0.16   3.47   3.52   3.47   3.52  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99499  Unlisted e&m service                              C   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  0XXX.00.00.0000000             25.5217 090 99      0.00   0.00   0.00
99500  Home visit prenatal                               I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99501  Home visit postnatal                              I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99502  Home visit nb care                                I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99503  Home visit resp therapy                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99504  Home visit mech ventilator                        I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99505  Home visit stoma care                             I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99506  Home visit im injection                           I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99507  Home visit cath maintain                          I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99509  Home visit day life activity                      I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99510  Home visit sing/m/fam couns                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99511  Home visit fecal/enema mgmt                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99512  Home visit for hemodialysis                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99600  Home visit nos                                    I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99601  Home infusion/visit 2 hrs                         I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99602  Home infusion each addtl hr                       I   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99605  Mtms by pharm np 15 min                           X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99606  Mtms by pharm est 15 min                          X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
99607  Mtms by pharm addl 15 min                         X   0.00   0.00     0.00     0.00     0.00     0.00   0.00   0.00   0.00   0.00  9XXX.00.00.0099999             25.5217 090 99      0.00   0.00   0.00
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